|
SCREW CORTEX SELFTAP 1.5X8MM
|
Facility
|
IP
|
$188.90
|
|
| Hospital Charge Code |
C270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.34 |
| Max. Negotiated Rate |
$45.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.34
|
|
|
SCREW CORTEX SELFTAP 1.5x9MM
|
Facility
|
IP
|
$138.30
|
|
| Hospital Charge Code |
270656261
|
|
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 1.5x9MM
|
Facility
|
OP
|
$138.30
|
|
| Hospital Charge Code |
270656261
|
|
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 2.0x10mm
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654764
|
|
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 2.0x10mm
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654764
|
|
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 2.0x11mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654768
|
|
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 2.0x11mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654768
|
|
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 2.0x12MM
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654770
|
|
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 2.0x12MM
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654770
|
|
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 2.0x13mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654772
|
|
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 2.0x13mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654772
|
|
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 2.0x14MM
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654774
|
|
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 2.0x14MM
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654774
|
|
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 SELF TAP 2.0X14MM
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$45.60
|
| Rate for Payer: Aetna Medicare Advantage |
$45.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.76
|
| Rate for Payer: Cigna Commercial |
$76.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.80
|
|
|
SCREW CORTEX SELF TAP 2.0X14MM
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$36.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.80
|
|
|
SCREW CORTEX SELFTAP 2.0x16MM
|
Facility
|
IP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634476
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$35.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
|
|
SCREW CORTEX SELFTAP 2.0x16MM
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654776
|
|
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 2.0x16MM
|
Facility
|
OP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634476
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$73.78 |
| Rate for Payer: Aetna Commercial |
$44.27
|
| Rate for Payer: Aetna Medicare Advantage |
$44.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.63
|
| Rate for Payer: Cigna Commercial |
$73.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
|
|
SCREW CORTEX SELFTAP 2.0x16MM
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654776
|
|
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 2.0x18mm
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654778
|
|
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 2.0x18mm
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654778
|
|
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 2.0x18MM
|
Facility
|
IP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$35.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
|
|
SCREW CORTEX SELFTAP 2.0x18MM
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634486
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$45.60
|
| Rate for Payer: Aetna Medicare Advantage |
$45.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.76
|
| Rate for Payer: Cigna Commercial |
$76.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.80
|
|
|
SCREW CORTEX SELFTAP 2.0x18MM
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634486
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$36.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.80
|
|
|
SCREW CORTEX SELFTAP 2.0x18MM
|
Facility
|
OP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$73.78 |
| Rate for Payer: Aetna Commercial |
$44.27
|
| Rate for Payer: Aetna Medicare Advantage |
$44.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.63
|
| Rate for Payer: Cigna Commercial |
$73.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
|