|
CORTICAL SCREW 4.0MM X 32MM
|
Facility
|
OP
|
$539.25
|
|
| Hospital Charge Code |
270657815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.89 |
| Max. Negotiated Rate |
$269.62 |
| Rate for Payer: Aetna Commercial |
$161.78
|
| Rate for Payer: Aetna Medicare Advantage |
$161.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$137.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$137.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$107.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$137.51
|
| Rate for Payer: Cigna Commercial |
$269.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.89
|
|
|
CORTICAL SCREW 4.0MM X 32MM
|
Facility
|
IP
|
$539.25
|
|
| Hospital Charge Code |
270657815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.89 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$107.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.89
|
|
|
CORTICAL SCREW 4.0MM X 34MM
|
Facility
|
OP
|
$539.25
|
|
| Hospital Charge Code |
270657816
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.89 |
| Max. Negotiated Rate |
$269.62 |
| Rate for Payer: Aetna Commercial |
$161.78
|
| Rate for Payer: Aetna Medicare Advantage |
$161.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$137.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$137.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$107.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$137.51
|
| Rate for Payer: Cigna Commercial |
$269.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.89
|
|
|
CORTICAL SCREW 4.0MM X 34MM
|
Facility
|
IP
|
$539.25
|
|
| Hospital Charge Code |
270657816
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.89 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$107.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.89
|
|
|
CORTICAL SCREW 4.0MM X 38MM
|
Facility
|
IP
|
$539.25
|
|
| Hospital Charge Code |
270657818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.89 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$107.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.89
|
|
|
CORTICAL SCREW 4.0MM X 38MM
|
Facility
|
OP
|
$539.25
|
|
| Hospital Charge Code |
270657818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.89 |
| Max. Negotiated Rate |
$269.62 |
| Rate for Payer: Aetna Commercial |
$161.78
|
| Rate for Payer: Aetna Medicare Advantage |
$161.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$137.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$137.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$107.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$137.51
|
| Rate for Payer: Cigna Commercial |
$269.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.89
|
|
|
CORTICAL SCREW 5.0MM X 30MM
|
Facility
|
OP
|
$1,107.95
|
|
| Hospital Charge Code |
270657800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$553.98 |
| Rate for Payer: Aetna Commercial |
$332.38
|
| Rate for Payer: Aetna Medicare Advantage |
$332.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$282.53
|
| Rate for Payer: Cigna Commercial |
$553.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0MM X 30MM
|
Facility
|
IP
|
$1,107.95
|
|
| Hospital Charge Code |
270657800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$268.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0MM X 42.5MM
|
Facility
|
OP
|
$1,107.95
|
|
| Hospital Charge Code |
270657801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$553.98 |
| Rate for Payer: Aetna Commercial |
$332.38
|
| Rate for Payer: Aetna Medicare Advantage |
$332.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$282.53
|
| Rate for Payer: Cigna Commercial |
$553.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0MM X 42.5MM
|
Facility
|
IP
|
$1,107.95
|
|
| Hospital Charge Code |
270657801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$268.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0MM X 50MM
|
Facility
|
OP
|
$1,107.95
|
|
| Hospital Charge Code |
270657840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$553.98 |
| Rate for Payer: Aetna Commercial |
$332.38
|
| Rate for Payer: Aetna Medicare Advantage |
$332.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$282.53
|
| Rate for Payer: Cigna Commercial |
$553.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0MM X 50MM
|
Facility
|
IP
|
$1,107.95
|
|
| Hospital Charge Code |
270657840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$268.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0,, X 40MM
|
Facility
|
IP
|
$1,107.95
|
|
| Hospital Charge Code |
270657806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$268.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICAL SCREW 5.0,, X 40MM
|
Facility
|
OP
|
$1,107.95
|
|
| Hospital Charge Code |
270657806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$553.98 |
| Rate for Payer: Aetna Commercial |
$332.38
|
| Rate for Payer: Aetna Medicare Advantage |
$332.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$282.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$221.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$282.53
|
| Rate for Payer: Cigna Commercial |
$553.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.19
|
|
|
CORTICALSCREWSELFCAP3.5X34MM
|
Facility
|
OP
|
$234.30
|
|
| Hospital Charge Code |
270656402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$117.15 |
| Rate for Payer: Aetna Commercial |
$70.29
|
| Rate for Payer: Aetna Medicare Advantage |
$70.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.75
|
| Rate for Payer: Cigna Commercial |
$117.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.15
|
|
|
CORTICALSCREWSELFCAP3.5X34MM
|
Facility
|
IP
|
$234.30
|
|
| Hospital Charge Code |
270656402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.15
|
|
|
CORTICAL STRUT FEMORAL
|
Facility
|
IP
|
$2,180.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270681921
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$327.00 |
| Max. Negotiated Rate |
$527.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$436.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$527.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$327.00
|
|
|
CORTICAL STRUT FEMORAL
|
Facility
|
OP
|
$2,180.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270681921
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$327.00 |
| Max. Negotiated Rate |
$1,090.00 |
| Rate for Payer: Aetna Commercial |
$654.00
|
| Rate for Payer: Aetna Medicare Advantage |
$654.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$555.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$555.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$436.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$555.90
|
| Rate for Payer: Cigna Commercial |
$1,090.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$527.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$327.00
|
|
|
CORTICOTROPIN RELATED HORMONE
|
Facility
|
OP
|
$585.17
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
3035084
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.07
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
CORTICOTROPIN RELATED HORMONE
|
Facility
|
IP
|
$585.17
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
3035084
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$87.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.78
|
|
|
CORTICOTROPIN REP INJ 400U/5ML
|
Facility
|
OP
|
$375.05
|
|
| Hospital Charge Code |
60628244
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$56.26 |
| Max. Negotiated Rate |
$187.53 |
| Rate for Payer: Aetna Commercial |
$112.52
|
| Rate for Payer: Aetna Medicare Advantage |
$112.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.64
|
| Rate for Payer: Cigna Commercial |
$187.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.26
|
|
|
CORTICOTROPIN REP INJ 400U/5ML
|
Facility
|
IP
|
$375.05
|
|
| Hospital Charge Code |
60628244
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$56.26 |
| Max. Negotiated Rate |
$90.76 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.26
|
|
|
Cortisol
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
39888016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
Cortisol
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
39888016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$52.81
|
| Rate for Payer: Aetna Medicare Advantage |
$16.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.72
|
| Rate for Payer: Cigna Commercial |
$16.30
|
| Rate for Payer: Cigna Medicare Advantage |
$8.15
|
| Rate for Payer: Clover Medicare Advantage |
$15.48
|
| Rate for Payer: EmblemHealth Commercial |
$48.90
|
| Rate for Payer: Humana Medicare Advantage |
$16.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.79
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$17.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.30
|
|
|
CORTISOL (24 HR UR)
|
Facility
|
OP
|
$139.25
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
3003241
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$52.81
|
| Rate for Payer: Aetna Medicare Advantage |
$16.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.72
|
| Rate for Payer: Cigna Commercial |
$16.30
|
| Rate for Payer: Cigna Medicare Advantage |
$8.15
|
| Rate for Payer: Clover Medicare Advantage |
$15.48
|
| Rate for Payer: EmblemHealth Commercial |
$48.90
|
| Rate for Payer: Humana Medicare Advantage |
$16.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$17.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.30
|
|