|
SCREW 4.5MMCORTEX SELFTAP125MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP125MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$43.58
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP130MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP130MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$43.58
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP135MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$43.58
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP135MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP140MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655824
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$43.58
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP140MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655824
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP145MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$43.58
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MMCORTEX SELFTAP145MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MM CORTEX SELFTAP14MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP14MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP16MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655719
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP16MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655719
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP18MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655720
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP18MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655720
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP20MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP20MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP22MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP22MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP26MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655725
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
|
|
SCREW 4.5MM CORTEX SELFTAP26MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655725
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP28MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP28MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP30MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|