|
SCREW CORTEX 2.4X 14 MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
270703506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$284.20 |
| Rate for Payer: Aetna Commercial |
$170.52
|
| Rate for Payer: Aetna Medicare Advantage |
$170.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.94
|
| Rate for Payer: Cigna Commercial |
$284.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.4 X 16 MM
|
Facility
|
IP
|
$568.40
|
|
| Hospital Charge Code |
270703507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$137.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.4 X 16 MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
270703507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$284.20 |
| Rate for Payer: Aetna Commercial |
$170.52
|
| Rate for Payer: Aetna Medicare Advantage |
$170.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.94
|
| Rate for Payer: Cigna Commercial |
$284.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.4 X 16MM
|
Facility
|
IP
|
$210.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.51 |
| Max. Negotiated Rate |
$50.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.51
|
|
|
SCREW CORTEX 2.4 X 16MM
|
Facility
|
OP
|
$210.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.51 |
| Max. Negotiated Rate |
$105.03 |
| Rate for Payer: Aetna Commercial |
$63.02
|
| Rate for Payer: Aetna Medicare Advantage |
$63.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.56
|
| Rate for Payer: Cigna Commercial |
$105.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.51
|
|
|
SCREW CORTEX 2.4X18MM
|
Facility
|
IP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$237.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
SCREW CORTEX 2.4X18MM
|
Facility
|
OP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: Aetna Commercial |
$294.00
|
| Rate for Payer: Aetna Medicare Advantage |
$294.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$249.90
|
| Rate for Payer: Cigna Commercial |
$490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
SCREW CORTEX 2.7x14MM
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7x14MM
|
Facility
|
OP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$64.12 |
| Rate for Payer: Aetna Commercial |
$38.48
|
| Rate for Payer: Aetna Medicare Advantage |
$38.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.70
|
| Rate for Payer: Cigna Commercial |
$64.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7X14 MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
270703508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$284.20 |
| Rate for Payer: Aetna Commercial |
$170.52
|
| Rate for Payer: Aetna Medicare Advantage |
$170.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.94
|
| Rate for Payer: Cigna Commercial |
$284.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.7X14 MM
|
Facility
|
IP
|
$568.40
|
|
| Hospital Charge Code |
270703508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$137.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.7x18MM
|
Facility
|
OP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$64.12 |
| Rate for Payer: Aetna Commercial |
$38.48
|
| Rate for Payer: Aetna Medicare Advantage |
$38.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.70
|
| Rate for Payer: Cigna Commercial |
$64.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7x18MM
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7x20MM
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7x20MM
|
Facility
|
OP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$64.12 |
| Rate for Payer: Aetna Commercial |
$38.48
|
| Rate for Payer: Aetna Medicare Advantage |
$38.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.70
|
| Rate for Payer: Cigna Commercial |
$64.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7X 24
|
Facility
|
OP
|
$525.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
SCREW CORTEX 2.7X 24
|
Facility
|
IP
|
$525.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$127.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$105.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
SCREW CORTEX 2.7x24mm
|
Facility
|
OP
|
$124.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665018
|
|
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 CORTEX 2.7x24mm
|
Facility
|
IP
|
$124.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665018
|
|
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 CORTEX 2.7X38MM SLF TAP
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270670541
|
|
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 CORTEX 2.7X38MM SLF TAP
|
Facility
|
IP
|
$135.75
|
|
| Hospital Charge Code |
270670541
|
|
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 CORTEX 2.7x55MM
|
Facility
|
OP
|
$135.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660329
|
|
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 CORTEX 2.7x55MM
|
Facility
|
IP
|
$135.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660329
|
|
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 CORTEX 2.7x6MM
|
Facility
|
OP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$64.12 |
| Rate for Payer: Aetna Commercial |
$38.48
|
| Rate for Payer: Aetna Medicare Advantage |
$38.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.70
|
| Rate for Payer: Cigna Commercial |
$64.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|
|
SCREW CORTEX 2.7x6MM
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|