|
SCREW CORTEX T8 STAR 2.7x12MM
|
Facility
|
IP
|
$168.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$40.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.30
|
|
|
SCREW CORTEX T8 STAR 2.7x12MM
|
Facility
|
OP
|
$168.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$84.33 |
| Rate for Payer: Aetna Commercial |
$50.59
|
| Rate for Payer: Aetna Medicare Advantage |
$50.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.01
|
| Rate for Payer: Cigna Commercial |
$84.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.30
|
|
|
SCREW CORTEX T8 STAR 2.7x18MM
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667169
|
|
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 2.7x18MM
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667169
|
|
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 2.7x22MM
|
Facility
|
OP
|
$168.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676294
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$84.33 |
| Rate for Payer: Aetna Commercial |
$50.59
|
| Rate for Payer: Aetna Medicare Advantage |
$50.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.01
|
| Rate for Payer: Cigna Commercial |
$84.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.30
|
|
|
SCREW CORTEX T8 STAR 2.7x22MM
|
Facility
|
IP
|
$168.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676294
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$40.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.30
|
|
|
SCREW CORTEX T8 STAR 2.7x26MM
|
Facility
|
OP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$81.88 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare Advantage |
$49.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$81.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x26MM
|
Facility
|
IP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676262N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$39.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x26MM
|
Facility
|
OP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676262N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$81.88 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare Advantage |
$49.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$81.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x26MM
|
Facility
|
IP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$39.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x28MM
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667168
|
|
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 2.7x28MM
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667168
|
|
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 2.7x34MM
|
Facility
|
OP
|
$159.00
|
|
| Hospital Charge Code |
270676980
|
|
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 2.7x34MM
|
Facility
|
IP
|
$159.00
|
|
| Hospital Charge Code |
270676980
|
|
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 2.7x38MM
|
Facility
|
IP
|
$168.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684227
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$40.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.30
|
|
|
SCREW CORTEX T8 STAR 2.7x38MM
|
Facility
|
OP
|
$168.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684227
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$84.33 |
| Rate for Payer: Aetna Commercial |
$50.59
|
| Rate for Payer: Aetna Medicare Advantage |
$50.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.01
|
| Rate for Payer: Cigna Commercial |
$84.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.30
|
|
|
SCREW CORTEX T8 STAR 2.7x40MM
|
Facility
|
OP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$81.88 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare Advantage |
$49.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$81.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x40MM
|
Facility
|
IP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$39.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x42MM
|
Facility
|
OP
|
$159.00
|
|
| Hospital Charge Code |
270676295
|
|
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 2.7x42MM
|
Facility
|
IP
|
$159.00
|
|
| Hospital Charge Code |
270676295
|
|
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 2.7x46MM
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676981
|
|
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 2.7x46MM
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676981
|
|
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 2.7x50MM
|
Facility
|
OP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$81.88 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare Advantage |
$49.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$81.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX T8 STAR 2.7x50MM
|
Facility
|
IP
|
$163.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$39.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.56
|
|
|
SCREW CORTEX TI 1.5 24
|
Facility
|
IP
|
$144.00
|
|
| Hospital Charge Code |
270661897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|