|
SCREW CORTEX SELFTAP 1.5x13mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x13mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x14mm
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$34.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELFTAP 1.5x14mm
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$42.73
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELFTAP 1.5x14MM
|
Facility
|
OP
|
$148.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.25 |
| Max. Negotiated Rate |
$74.15 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare Advantage |
$44.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.82
|
| Rate for Payer: Cigna Commercial |
$74.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
|
|
SCREW CORTEX SELFTAP 1.5x14MM
|
Facility
|
IP
|
$148.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.25 |
| Max. Negotiated Rate |
$35.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
|
|
SCREW CORTEX SELFTAP 1.5x16mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x16mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x18mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x18mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x20mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x20mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x22mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x22mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x24mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x24mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x6MM
|
Facility
|
IP
|
$138.30
|
|
| Hospital Charge Code |
270656257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x6MM
|
Facility
|
OP
|
$138.30
|
|
| Hospital Charge Code |
270656257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270606012
|
|
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 CORTEX SELFTAP 1.5x7mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270606012
|
|
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 CORTEX SELFTAP 1.5x8mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x8mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5X8MM
|
Facility
|
OP
|
$188.90
|
|
| Hospital Charge Code |
C270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.34 |
| Max. Negotiated Rate |
$94.45 |
| Rate for Payer: Aetna Commercial |
$56.67
|
| Rate for Payer: Aetna Medicare Advantage |
$56.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.17
|
| Rate for Payer: Cigna Commercial |
$94.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.34
|
|