|
SCREW 2.7mm TITAN CORTEX 32mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 32mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 34mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 34mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 36mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 36mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 38mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 38mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 40mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 40mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 6mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 6mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 8mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mm TITAN CORTEX 8mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 2.7mmx22mm
|
Facility
|
OP
|
$625.00
|
|
| Hospital Charge Code |
270647993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.75 |
| Max. Negotiated Rate |
$312.50 |
| Rate for Payer: Aetna Commercial |
$187.50
|
| Rate for Payer: Aetna Medicare Advantage |
$187.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$159.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$159.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$159.38
|
| Rate for Payer: Cigna Commercial |
$312.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$151.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.75
|
|
|
SCREW 2.7mmx22mm
|
Facility
|
IP
|
$625.00
|
|
| Hospital Charge Code |
270647993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.75 |
| Max. Negotiated Rate |
$151.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$151.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.75
|
|
|
SCREW 2.7MM X 22MM THREADED PE
|
Facility
|
IP
|
$495.00
|
|
| Hospital Charge Code |
270661794
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.25 |
| Max. Negotiated Rate |
$119.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
|
|
SCREW 2.7MM X 22MM THREADED PE
|
Facility
|
OP
|
$495.00
|
|
| Hospital Charge Code |
270661794
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.25 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$148.50
|
| Rate for Payer: Aetna Medicare Advantage |
$148.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.22
|
| Rate for Payer: Cigna Commercial |
$247.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
|
|
SCREW 2.7X12MM
|
Facility
|
OP
|
$700.00
|
|
| Hospital Charge Code |
270669675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$210.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW 2.7X12MM
|
Facility
|
IP
|
$700.00
|
|
| Hospital Charge Code |
270669675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW 2.7x12 NON LOCKG CO-2712
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270648047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$93.17 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SCREW 2.7x12 NON LOCKG CO-2712
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270648047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$115.50
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SCREW 2.7X14MM
|
Facility
|
IP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$447.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
SCREW 2.7X14MM
|
Facility
|
OP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna Commercial |
$555.00
|
| Rate for Payer: Aetna Medicare Advantage |
$555.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.75
|
| Rate for Payer: Cigna Commercial |
$925.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
SCREW 2.7x14 NNLCK 8140-27-014
|
Facility
|
OP
|
$360.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661576
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Aetna Medicare Advantage |
$108.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.80
|
| Rate for Payer: Cigna Commercial |
$180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.00
|
|