|
SCREW6.5MM CANC 16MM
|
Facility
|
IP
|
$145.50
|
|
| Hospital Charge Code |
270655856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.82 |
| Max. Negotiated Rate |
$35.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.82
|
|
|
SCREW6.5MM CANC 16MM
|
Facility
|
IP
|
$139.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655850
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.86 |
| Max. Negotiated Rate |
$33.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.86
|
|
|
SCREW6.5MM CANC 16MM
|
Facility
|
IP
|
$149.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.48 |
| Max. Negotiated Rate |
$36.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.48
|
|
|
SCREW 6.5MM CANC 16 THRD 65MM
|
Facility
|
OP
|
$139.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687941
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.86 |
| Max. Negotiated Rate |
$69.53 |
| Rate for Payer: Aetna Commercial |
$41.72
|
| Rate for Payer: Aetna Medicare Advantage |
$41.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.46
|
| Rate for Payer: Cigna Commercial |
$69.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.86
|
|
|
SCREW 6.5MM CANC 16 THRD 65MM
|
Facility
|
IP
|
$139.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687941
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.86 |
| Max. Negotiated Rate |
$33.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.86
|
|
|
SCREW 6.5mm CANC 16X50 2332051
|
Facility
|
IP
|
$79.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270610371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X50 2332051
|
Facility
|
OP
|
$79.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270610371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$39.73 |
| Rate for Payer: Aetna Commercial |
$23.84
|
| Rate for Payer: Aetna Medicare Advantage |
$23.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.26
|
| Rate for Payer: Cigna Commercial |
$39.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X65 2332066
|
Facility
|
OP
|
$79.45
|
|
| Hospital Charge Code |
270610374
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$39.73 |
| Rate for Payer: Aetna Commercial |
$23.84
|
| Rate for Payer: Aetna Medicare Advantage |
$23.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.26
|
| Rate for Payer: Cigna Commercial |
$39.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X65 2332066
|
Facility
|
IP
|
$79.45
|
|
| Hospital Charge Code |
270610374
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X70 2332071
|
Facility
|
OP
|
$79.45
|
|
| Hospital Charge Code |
270610375
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$39.73 |
| Rate for Payer: Aetna Commercial |
$23.84
|
| Rate for Payer: Aetna Medicare Advantage |
$23.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.26
|
| Rate for Payer: Cigna Commercial |
$39.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X70 2332071
|
Facility
|
IP
|
$79.45
|
|
| Hospital Charge Code |
270610375
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X75 2332076
|
Facility
|
IP
|
$79.45
|
|
| Hospital Charge Code |
270610376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X75 2332076
|
Facility
|
OP
|
$79.45
|
|
| Hospital Charge Code |
270610376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$39.73 |
| Rate for Payer: Aetna Commercial |
$23.84
|
| Rate for Payer: Aetna Medicare Advantage |
$23.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.26
|
| Rate for Payer: Cigna Commercial |
$39.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X80 2332081
|
Facility
|
OP
|
$79.45
|
|
| Hospital Charge Code |
270610377
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$39.73 |
| Rate for Payer: Aetna Commercial |
$23.84
|
| Rate for Payer: Aetna Medicare Advantage |
$23.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.26
|
| Rate for Payer: Cigna Commercial |
$39.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X80 2332081
|
Facility
|
IP
|
$79.45
|
|
| Hospital Charge Code |
270610377
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.92
|
|
|
SCREW 6.5mm CANC 16X85 2332086
|
Facility
|
OP
|
$87.35
|
|
| Hospital Charge Code |
270610378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$43.67 |
| Rate for Payer: Aetna Commercial |
$26.20
|
| Rate for Payer: Aetna Medicare Advantage |
$26.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.27
|
| Rate for Payer: Cigna Commercial |
$43.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.10
|
|
|
SCREW 6.5mm CANC 16X85 2332086
|
Facility
|
IP
|
$87.35
|
|
| Hospital Charge Code |
270610378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.10
|
|
|
SCREW 6.5mm CANC 16X90 2332091
|
Facility
|
IP
|
$87.35
|
|
| Hospital Charge Code |
270610379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.10
|
|
|
SCREW 6.5mm CANC 16X90 2332091
|
Facility
|
OP
|
$87.35
|
|
| Hospital Charge Code |
270610379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$43.67 |
| Rate for Payer: Aetna Commercial |
$26.20
|
| Rate for Payer: Aetna Medicare Advantage |
$26.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.27
|
| Rate for Payer: Cigna Commercial |
$43.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.10
|
|
|
SCREW 6.5mm CANC 16x95 2332096
|
Facility
|
OP
|
$87.35
|
|
| Hospital Charge Code |
270610380
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$43.67 |
| Rate for Payer: Aetna Commercial |
$26.20
|
| Rate for Payer: Aetna Medicare Advantage |
$26.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.27
|
| Rate for Payer: Cigna Commercial |
$43.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.10
|
|
|
SCREW 6.5mm CANC 16x95 2332096
|
Facility
|
IP
|
$87.35
|
|
| Hospital Charge Code |
270610380
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.10
|
|
|
SCREW 6.5mm CANC 32mm THR 45mm
|
Facility
|
OP
|
$80.00
|
|
| Hospital Charge Code |
270610384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$24.00
|
| Rate for Payer: Aetna Medicare Advantage |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.40
|
| Rate for Payer: Cigna Commercial |
$40.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
|
|
SCREW 6.5mm CANC 32mm THR 45mm
|
Facility
|
IP
|
$80.00
|
|
| Hospital Charge Code |
270610384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$19.36 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
|
|
SCREW 6.5mm CANC 32X90 2333091
|
Facility
|
OP
|
$109.70
|
|
| Hospital Charge Code |
270610392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$54.85 |
| Rate for Payer: Aetna Commercial |
$32.91
|
| Rate for Payer: Aetna Medicare Advantage |
$32.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.97
|
| Rate for Payer: Cigna Commercial |
$54.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.45
|
|
|
SCREW 6.5mm CANC 32X90 2333091
|
Facility
|
IP
|
$109.70
|
|
| Hospital Charge Code |
270610392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$26.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.45
|
|