|
SCREW CORTEX T8 STAR 2.4x16MM
|
Facility
|
IP
|
$246.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$59.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.01
|
|
|
SCREW CORTEX T8 STAR 2.4x18MM
|
Facility
|
OP
|
$246.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$123.35 |
| Rate for Payer: Aetna Commercial |
$74.01
|
| Rate for Payer: Aetna Medicare Advantage |
$74.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.91
|
| Rate for Payer: Cigna Commercial |
$123.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.01
|
|
|
SCREW CORTEX T8 STAR 2.4x18MM
|
Facility
|
IP
|
$246.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$59.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.01
|
|
|
SCREW CORTEX T8 STAR 2.4x20MM
|
Facility
|
IP
|
$239.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$57.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
SCREW CORTEX T8 STAR 2.4x20MM
|
Facility
|
OP
|
$239.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$119.75 |
| Rate for Payer: Aetna Commercial |
$71.85
|
| Rate for Payer: Aetna Medicare Advantage |
$71.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.07
|
| Rate for Payer: Cigna Commercial |
$119.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
SCREW CORTEX T8 STAR 2.4x22MM
|
Facility
|
OP
|
$232.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663937
|
|
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
|
|
|
SCREW CORTEX T8 STAR 2.4x22MM
|
Facility
|
IP
|
$232.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663937
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$56.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|
|
SCREW CORTEX T8 STAR 2.4x24mm
|
Facility
|
IP
|
$239.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$57.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
SCREW CORTEX T8 STAR 2.4x24mm
|
Facility
|
OP
|
$239.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$119.75 |
| Rate for Payer: Aetna Commercial |
$71.85
|
| Rate for Payer: Aetna Medicare Advantage |
$71.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.07
|
| Rate for Payer: Cigna Commercial |
$119.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
SCREW CORTEX T8 STAR 2.4x26MM
|
Facility
|
IP
|
$232.50
|
|
| Hospital Charge Code |
270664958
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$56.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|
|
SCREW CORTEX T8 STAR 2.4x26MM
|
Facility
|
OP
|
$232.50
|
|
| Hospital Charge Code |
270664958
|
|
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
|
|
|
SCREW CORTEX T8 STAR 2.4x28mm
|
Facility
|
OP
|
$232.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661260
|
|
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
|
|
|
SCREW CORTEX T8 STAR 2.4x28mm
|
Facility
|
IP
|
$232.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$56.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|
|
SCREW CORTEX T8 STAR 2.4x36MM
|
Facility
|
IP
|
$232.50
|
|
| Hospital Charge Code |
270676477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$56.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|
|
SCREW CORTEX T8 STAR 2.4x36MM
|
Facility
|
OP
|
$232.50
|
|
| Hospital Charge Code |
270676477
|
|
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
|
|
|
SCREW CORTEX T8 STAR 2.4x6MM
|
Facility
|
OP
|
$239.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$119.75 |
| Rate for Payer: Aetna Commercial |
$71.85
|
| Rate for Payer: Aetna Medicare Advantage |
$71.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.07
|
| Rate for Payer: Cigna Commercial |
$119.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
SCREW CORTEX T8 STAR 2.4x6MM
|
Facility
|
IP
|
$239.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$57.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
SCREW CORTEX T8 STAR 2.4x8MM
|
Facility
|
IP
|
$232.50
|
|
| Hospital Charge Code |
270661616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$56.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|
|
SCREW CORTEX T8 STAR 2.4x8MM
|
Facility
|
OP
|
$232.50
|
|
| Hospital Charge Code |
270661616
|
|
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
|
|
|
SCREW CORTEX T8 STAR 2.4x9MM
|
Facility
|
OP
|
$232.50
|
|
| Hospital Charge Code |
270670542
|
|
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
|
|
|
SCREW CORTEX T8 STAR 2.4x9MM
|
Facility
|
IP
|
$232.50
|
|
| Hospital Charge Code |
270670542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$56.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.88
|
|
|
SCREW CORTEX T8 STAR 2.7x10MM
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Medicare Advantage |
$47.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.55
|
| Rate for Payer: Cigna Commercial |
$79.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.85
|
|
|
SCREW CORTEX T8 STAR 2.7x10MM
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$38.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.85
|
|
|
SCREW CORTEX T8 STAR 2.7x10MM
|
Facility
|
OP
|
$159.00
|
|
| Hospital Charge Code |
270673130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Medicare Advantage |
$47.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.55
|
| Rate for Payer: Cigna Commercial |
$79.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.85
|
|
|
SCREW CORTEX T8 STAR 2.7x10MM
|
Facility
|
IP
|
$159.00
|
|
| Hospital Charge Code |
270673130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$38.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.85
|
|