|
SCREW CORTEX SELFTAP 4.5x30mm
|
Facility
|
IP
|
$93.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.09 |
| Max. Negotiated Rate |
$22.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.09
|
|
|
SCREW CORTEX SELFTAP 4.5x30mm
|
Facility
|
OP
|
$93.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270660392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.09 |
| Max. Negotiated Rate |
$46.95 |
| Rate for Payer: Aetna Commercial |
$28.17
|
| Rate for Payer: Aetna Medicare Advantage |
$28.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.94
|
| Rate for Payer: Cigna Commercial |
$46.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.09
|
|
|
SCREW CORTEX SELFTAP 4.5X32MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603610
|
|
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 4.5X32MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603610
|
|
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 4.5x34mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603611
|
|
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 4.5x34mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603611
|
|
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 4.5x36MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603612
|
|
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 4.5x36MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603612
|
|
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 4.5x38MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270606028
|
|
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 4.5x38MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270606028
|
|
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 4.5x40MM
|
Facility
|
OP
|
$93.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.09 |
| Max. Negotiated Rate |
$46.95 |
| Rate for Payer: Aetna Commercial |
$28.17
|
| Rate for Payer: Aetna Medicare Advantage |
$28.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.94
|
| Rate for Payer: Cigna Commercial |
$46.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.09
|
|
|
SCREW CORTEX SELFTAP 4.5x40MM
|
Facility
|
IP
|
$93.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.09 |
| Max. Negotiated Rate |
$22.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.09
|
|
|
SCREW CORTEX SELFTAP 4.5x44mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603618
|
|
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 4.5x44mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603618
|
|
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 4.5x46mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603619
|
|
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 4.5x46mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603619
|
|
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 4.5x52MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603624
|
|
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 4.5x52MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603624
|
|
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 4.5x56mm
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645543
|
|
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 4.5x56mm
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645543
|
|
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 4.5x64MM
|
Facility
|
IP
|
$88.50
|
|
| Hospital Charge Code |
270676983
|
|
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 4.5x64MM
|
Facility
|
OP
|
$88.50
|
|
| Hospital Charge Code |
270676983
|
|
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 4.5x70mm
|
Facility
|
IP
|
$88.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645544
|
|
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 4.5x70mm
|
Facility
|
OP
|
$88.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645544
|
|
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 SLF 30 MM 2.4 MM
|
Facility
|
OP
|
$232.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659709
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Aetna Commercial |
$69.75
|
| Rate for Payer: Aetna Medicare Advantage |
$69.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.29
|
| Rate for Payer: Cigna Commercial |
$116.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|