|
SCREW CORTEX SELFTAP 2.0x20MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654780
|
|
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 2.0x20MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654780
|
|
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 2.0x22mm
|
Facility
|
OP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634478
|
|
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 2.0x22mm
|
Facility
|
IP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634478
|
|
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 2.0x22MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654782
|
|
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 2.0x22MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654782
|
|
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 2.0x24mm
|
Facility
|
IP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634479
|
|
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 2.0x24mm
|
Facility
|
OP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270634479
|
|
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 2.0x24MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654785
|
|
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 2.0x24MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654785
|
|
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 2.0x26MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654786
|
|
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 2.0x26MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654786
|
|
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 2.0x28MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654787
|
|
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 2.0x28MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654787
|
|
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 2.0x30MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654788
|
|
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 2.0x30MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654788
|
|
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 2.0x32MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654793
|
|
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 2.0x32MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654793
|
|
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 SELF TAP 2.0 X 6M
|
Facility
|
IP
|
$143.25
|
|
| Hospital Charge Code |
270667563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$34.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.49
|
|
|
SCREW CORTEX SELF TAP 2.0 X 6M
|
Facility
|
OP
|
$143.25
|
|
| Hospital Charge Code |
270667563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$71.62 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare Advantage |
$42.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.53
|
| Rate for Payer: Cigna Commercial |
$71.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.49
|
|
|
SCREW CORTEX SELFTAP 2.0x6MM
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654754
|
|
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 2.0x6MM
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654754
|
|
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 SELF TAP 2.0x7mm
|
Facility
|
IP
|
$143.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$34.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.49
|
|
|
SCREW CORTEX SELF TAP 2.0x7mm
|
Facility
|
OP
|
$143.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$71.62 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare Advantage |
$42.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.53
|
| Rate for Payer: Cigna Commercial |
$71.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.49
|
|
|
SCREW CORTEX SELFTAP 2.0x7mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654759
|
|
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
|
|