|
SCREW VAL KRELILOCK TL 3.0X18
|
Facility
|
OP
|
$1,515.00
|
|
| Hospital Charge Code |
270702474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.51 |
| Max. Negotiated Rate |
$757.50 |
| Rate for Payer: Aetna Commercial |
$575.70
|
| Rate for Payer: Aetna Medicare Advantage |
$454.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$386.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$386.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$386.32
|
| Rate for Payer: Cigna Commercial |
$757.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$366.63
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$333.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.15
|
|
|
SCREW VAL KRELILOCK TL 3.0X18
|
Facility
|
IP
|
$1,515.00
|
|
| Hospital Charge Code |
270702474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.25 |
| Max. Negotiated Rate |
$366.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$366.63
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$333.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.25
|
|
|
SCREW VAL KREULK TI 3.0X16MM
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696333
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW VAL KREULK TI 3.0X16MM
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696333
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.09
|
|
|
SCREW VAL KREULOCK TI 2.4X10
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696715
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW VAL KREULOCK TI 2.4X10
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696715
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.09
|
|
|
SCREW VAL KREULOCK TI 2.4X12
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.09
|
|
|
SCREW VAL KREULOCK TI 2.4X12
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW VA LOCKING 2.4mm X 16mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 16mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4mm X 18mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4mm X 18mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 24mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 24mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4mm X 26mm
|
Facility
|
IP
|
$577.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645537
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$139.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$115.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.84
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$127.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.68
|
|
|
SCREW VA LOCKING 2.4mm X 26mm
|
Facility
|
OP
|
$577.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645537
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$288.93 |
| Rate for Payer: Aetna Commercial |
$219.58
|
| Rate for Payer: Aetna Medicare Advantage |
$173.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$147.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$147.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$115.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$147.35
|
| Rate for Payer: Cigna Commercial |
$288.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.84
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$127.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.31
|
|
|
SCREW VA LOCKING 2.4x10mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x10mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4x11mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685322
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x11mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685322
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4x12mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4x12mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x13mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x13mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|
|
SCREW VA LOCKING 2.4x14mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645539
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$226.18
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$130.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.77
|
|