|
SCREW 2.7 CORTEX TITANIUM 14MM
|
Facility
|
IP
|
$124.50
|
|
| Hospital Charge Code |
270656717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$30.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.68
|
|
|
SCREW 2.7 CORTEX TITANIUM 14MM
|
Facility
|
OP
|
$124.50
|
|
| Hospital Charge Code |
270656717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Aetna Commercial |
$37.35
|
| Rate for Payer: Aetna Medicare Advantage |
$37.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.75
|
| Rate for Payer: Cigna Commercial |
$62.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.68
|
|
|
SCREW 2.7 CORTICAL 20 2324021
|
Facility
|
OP
|
$44.70
|
|
| Hospital Charge Code |
270610127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.71 |
| Max. Negotiated Rate |
$22.35 |
| Rate for Payer: Aetna Commercial |
$13.41
|
| Rate for Payer: Aetna Medicare Advantage |
$13.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.40
|
| Rate for Payer: Cigna Commercial |
$22.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.71
|
|
|
SCREW 2.7 CORTICAL 20 2324021
|
Facility
|
IP
|
$44.70
|
|
| Hospital Charge Code |
270610127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.71 |
| Max. Negotiated Rate |
$10.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.71
|
|
|
SCREW 2.7m CORTICL 14m 2324015
|
Facility
|
OP
|
$36.25
|
|
| Hospital Charge Code |
270610122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$18.12 |
| Rate for Payer: Aetna Commercial |
$10.88
|
| Rate for Payer: Aetna Medicare Advantage |
$10.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.24
|
| Rate for Payer: Cigna Commercial |
$18.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.44
|
|
|
SCREW 2.7m CORTICL 14m 2324015
|
Facility
|
IP
|
$36.25
|
|
| Hospital Charge Code |
270610122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$8.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.44
|
|
|
SCREW 2.7m CORTICL 18m 2324019
|
Facility
|
IP
|
$36.25
|
|
| Hospital Charge Code |
270610125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$8.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.44
|
|
|
SCREW 2.7m CORTICL 18m 2324019
|
Facility
|
OP
|
$36.25
|
|
| Hospital Charge Code |
270610125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$18.12 |
| Rate for Payer: Aetna Commercial |
$10.88
|
| Rate for Payer: Aetna Medicare Advantage |
$10.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.24
|
| Rate for Payer: Cigna Commercial |
$18.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.44
|
|
|
SCREW 2.7 METAPHYSEAL SLF-TPNG
|
Facility
|
OP
|
$200.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.07 |
| Max. Negotiated Rate |
$100.25 |
| Rate for Payer: Aetna Commercial |
$60.15
|
| Rate for Payer: Aetna Medicare Advantage |
$60.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.13
|
| Rate for Payer: Cigna Commercial |
$100.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.07
|
|
|
SCREW 2.7 METAPHYSEAL SLF-TPNG
|
Facility
|
IP
|
$200.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.07 |
| Max. Negotiated Rate |
$48.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.07
|
|
|
SCREW 2.7 METAPHYSEAL SLF-TPNG
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$45.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.35
|
|
|
SCREW 2.7 METAPHYSEAL SLF-TPNG
|
Facility
|
OP
|
$189.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$56.70
|
| Rate for Payer: Aetna Medicare Advantage |
$56.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.20
|
| Rate for Payer: Cigna Commercial |
$94.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.35
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270656894
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$67.88 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Aetna Medicare Advantage |
$40.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.62
|
| Rate for Payer: Cigna Commercial |
$67.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
IP
|
$135.75
|
|
| Hospital Charge Code |
270656890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$32.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
OP
|
$135.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$67.88 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Aetna Medicare Advantage |
$40.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.62
|
| Rate for Payer: Cigna Commercial |
$67.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
IP
|
$135.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$32.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
IP
|
$135.75
|
|
| Hospital Charge Code |
270656894
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$32.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270656892
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$67.88 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Aetna Medicare Advantage |
$40.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.62
|
| Rate for Payer: Cigna Commercial |
$67.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270656890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$67.88 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Aetna Medicare Advantage |
$40.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.62
|
| Rate for Payer: Cigna Commercial |
$67.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
IP
|
$135.75
|
|
| Hospital Charge Code |
270656902
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$32.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
IP
|
$135.75
|
|
| Hospital Charge Code |
270656892
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$32.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7MM CORTEX SELF TAP
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270656902
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$67.88 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Aetna Medicare Advantage |
$40.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.62
|
| Rate for Payer: Cigna Commercial |
$67.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW 2.7 MM CORT FT 18 MM
|
Facility
|
IP
|
$247.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$59.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|
|
SCREW 2.7 MM CORT FT 18 MM
|
Facility
|
OP
|
$247.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$74.25
|
| Rate for Payer: Aetna Medicare Advantage |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.11
|
| Rate for Payer: Cigna Commercial |
$123.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|
|
SCREW 2.7MM LOCKING MDS 12MM
|
Facility
|
OP
|
$1,017.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$152.62 |
| Max. Negotiated Rate |
$508.75 |
| Rate for Payer: Aetna Commercial |
$305.25
|
| Rate for Payer: Aetna Medicare Advantage |
$305.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$259.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$259.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$203.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$259.46
|
| Rate for Payer: Cigna Commercial |
$508.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$246.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$152.62
|
|