|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
IP
|
$519.00
|
|
| Hospital Charge Code |
270656218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$125.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
OP
|
$519.00
|
|
| Hospital Charge Code |
270656225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Aetna Medicare Advantage |
$155.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.34
|
| Rate for Payer: Cigna Commercial |
$259.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
IP
|
$519.00
|
|
| Hospital Charge Code |
270656216
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$125.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
OP
|
$519.00
|
|
| Hospital Charge Code |
270656218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Aetna Medicare Advantage |
$155.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.34
|
| Rate for Payer: Cigna Commercial |
$259.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
IP
|
$519.00
|
|
| Hospital Charge Code |
270656213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$125.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
IP
|
$519.00
|
|
| Hospital Charge Code |
270656225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$125.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
IP
|
$519.00
|
|
| Hospital Charge Code |
270656214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$125.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
OP
|
$519.00
|
|
| Hospital Charge Code |
270656213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Aetna Medicare Advantage |
$155.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.34
|
| Rate for Payer: Cigna Commercial |
$259.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
OP
|
$519.00
|
|
| Hospital Charge Code |
270656214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Aetna Medicare Advantage |
$155.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.34
|
| Rate for Payer: Cigna Commercial |
$259.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM LOCKING SELFTAP
|
Facility
|
OP
|
$519.00
|
|
| Hospital Charge Code |
270656216
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Aetna Medicare Advantage |
$155.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.34
|
| Rate for Payer: Cigna Commercial |
$259.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.85
|
|
|
SCREW 3.5MM TI 34MM
|
Facility
|
IP
|
$87.75
|
|
| Hospital Charge Code |
270656817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$21.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.16
|
|
|
SCREW 3.5MM TI 34MM
|
Facility
|
OP
|
$87.75
|
|
| Hospital Charge Code |
270656817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$43.88 |
| Rate for Payer: Aetna Commercial |
$26.32
|
| Rate for Payer: Aetna Medicare Advantage |
$26.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.38
|
| Rate for Payer: Cigna Commercial |
$43.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.16
|
|
|
SCREW 3.5MM TI SHAFT 36MM
|
Facility
|
OP
|
$74.25
|
|
| Hospital Charge Code |
270656845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Aetna Commercial |
$22.27
|
| Rate for Payer: Aetna Medicare Advantage |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.93
|
| Rate for Payer: Cigna Commercial |
$37.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
|
|
SCREW 3.5MM TI SHAFT 36MM
|
Facility
|
IP
|
$74.25
|
|
| Hospital Charge Code |
270656845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
|
|
SCREW 3.5MM TI SHAFT 38MM
|
Facility
|
IP
|
$87.75
|
|
| Hospital Charge Code |
270656843
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$21.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.16
|
|
|
SCREW 3.5MM TI SHAFT 38MM
|
Facility
|
OP
|
$74.25
|
|
| Hospital Charge Code |
270656850
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Aetna Commercial |
$22.27
|
| Rate for Payer: Aetna Medicare Advantage |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.93
|
| Rate for Payer: Cigna Commercial |
$37.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
|
|
SCREW 3.5MM TI SHAFT 38MM
|
Facility
|
IP
|
$74.25
|
|
| Hospital Charge Code |
270656850
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
|
|
SCREW 3.5MM TI SHAFT 38MM
|
Facility
|
OP
|
$87.75
|
|
| Hospital Charge Code |
270656843
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$43.88 |
| Rate for Payer: Aetna Commercial |
$26.32
|
| Rate for Payer: Aetna Medicare Advantage |
$26.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.38
|
| Rate for Payer: Cigna Commercial |
$43.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.16
|
|
|
SCREW 3.5 MMx 20 MM LP NONLOCK
|
Facility
|
IP
|
$370.00
|
|
| Hospital Charge Code |
270701884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$89.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.50
|
|
|
SCREW 3.5 MMx 20 MM LP NONLOCK
|
Facility
|
OP
|
$370.00
|
|
| Hospital Charge Code |
270701884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$185.00 |
| Rate for Payer: Aetna Commercial |
$111.00
|
| Rate for Payer: Aetna Medicare Advantage |
$111.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$94.35
|
| Rate for Payer: Cigna Commercial |
$185.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.50
|
|
|
SCREW 3.5MM X 28MM LOCKING
|
Facility
|
OP
|
$1,575.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.25 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Aetna Commercial |
$472.50
|
| Rate for Payer: Aetna Medicare Advantage |
$472.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$315.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$401.62
|
| Rate for Payer: Cigna Commercial |
$787.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$381.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
|
|
SCREW 3.5MM X 28MM LOCKING
|
Facility
|
IP
|
$1,575.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.25 |
| Max. Negotiated Rate |
$381.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$381.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
|
|
SCREW 3.5MM X 34MM LOCLING SCR
|
Facility
|
IP
|
$1,575.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.25 |
| Max. Negotiated Rate |
$381.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$381.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
|
|
SCREW 3.5MM X 34MM LOCLING SCR
|
Facility
|
OP
|
$1,575.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.25 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Aetna Commercial |
$472.50
|
| Rate for Payer: Aetna Medicare Advantage |
$472.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$315.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$401.62
|
| Rate for Payer: Cigna Commercial |
$787.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$381.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
|
|
SCREW 3.5MM X 36MM LOCKING
|
Facility
|
OP
|
$1,575.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.25 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Aetna Commercial |
$472.50
|
| Rate for Payer: Aetna Medicare Advantage |
$472.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$315.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$401.62
|
| Rate for Payer: Cigna Commercial |
$787.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$381.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
|