|
SCREW CORTEX SELFTAP 2.7x8mm
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270673150
|
|
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 SELF TAP 2x13MM
|
Facility
|
IP
|
$143.25
|
|
| Hospital Charge Code |
270675317
|
|
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 2x13MM
|
Facility
|
OP
|
$143.25
|
|
| Hospital Charge Code |
270675317
|
|
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 2x18MM
|
Facility
|
IP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|
|
SCREW CORTEX SELFTAP 2x18MM
|
Facility
|
OP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$77.58 |
| Rate for Payer: Aetna Commercial |
$46.55
|
| Rate for Payer: Aetna Medicare Advantage |
$46.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.56
|
| Rate for Payer: Cigna Commercial |
$77.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|
|
SCREW CORTEX SELFTAP 2x24MM
|
Facility
|
OP
|
$150.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270641312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$75.33 |
| Rate for Payer: Aetna Commercial |
$45.20
|
| Rate for Payer: Aetna Medicare Advantage |
$45.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.42
|
| Rate for Payer: Cigna Commercial |
$75.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.60
|
|
|
SCREW CORTEX SELFTAP 2x24MM
|
Facility
|
IP
|
$150.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270641312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$36.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.60
|
|
|
SCREW CORTEX SELFTAP 2x26MM
|
Facility
|
IP
|
$150.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270641313
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$36.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.60
|
|
|
SCREW CORTEX SELFTAP 2x26MM
|
Facility
|
OP
|
$150.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270641313
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$75.33 |
| Rate for Payer: Aetna Commercial |
$45.20
|
| Rate for Payer: Aetna Medicare Advantage |
$45.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.42
|
| Rate for Payer: Cigna Commercial |
$75.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.60
|
|
|
SCREW CORTEX SELF TAP 3.5x20MM
|
Facility
|
OP
|
$93.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$46.55 |
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Medicare Advantage |
$27.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$46.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.96
|
|
|
SCREW CORTEX SELF TAP 3.5x20MM
|
Facility
|
IP
|
$93.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$22.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.96
|
|
|
SCREW CORTEX SELFTAP 4.5x14mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELFTAP 4.5x14mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELF TAP 4.5X16MM
|
Facility
|
OP
|
$88.50
|
|
| Hospital Charge Code |
270673126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$44.25 |
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna Medicare Advantage |
$26.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.57
|
| Rate for Payer: Cigna Commercial |
$44.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
|
|
SCREW CORTEX SELF TAP 4.5X16MM
|
Facility
|
IP
|
$88.50
|
|
| Hospital Charge Code |
270673126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
|
|
SCREW CORTEX SELF TAP 4.5x20MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELF TAP 4.5x20MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELF TAP 4.5x22MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270627315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELF TAP 4.5x22MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270627315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELFTAP 4.5x24mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660393
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELFTAP 4.5x24mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660393
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELFTAP 4.5x24MM
|
Facility
|
OP
|
$88.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$44.25 |
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna Medicare Advantage |
$26.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.57
|
| Rate for Payer: Cigna Commercial |
$44.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
|
|
SCREW CORTEX SELFTAP 4.5x24MM
|
Facility
|
IP
|
$88.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
|
|
SCREW CORTEX SELFTAP 4.5x28mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603606
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW CORTEX SELFTAP 4.5x28mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603606
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|