|
SCREW CTR-DRV 2.7x18mm
|
Facility
|
OP
|
$171.25
|
|
| Hospital Charge Code |
270610984
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$85.62 |
| Rate for Payer: Aetna Commercial |
$51.38
|
| Rate for Payer: Aetna Medicare Advantage |
$51.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.67
|
| Rate for Payer: Cigna Commercial |
$85.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.69
|
|
|
SCREW CTR-DRV 2.7x18mm
|
Facility
|
IP
|
$171.25
|
|
| Hospital Charge Code |
270610984
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$41.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.69
|
|
|
SCREW CTR-DRV 2.7x20mm
|
Facility
|
IP
|
$176.15
|
|
| Hospital Charge Code |
270610985
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$42.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.42
|
|
|
SCREW CTR-DRV 2.7x20mm
|
Facility
|
OP
|
$176.15
|
|
| Hospital Charge Code |
270610985
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$88.08 |
| Rate for Payer: Aetna Commercial |
$52.84
|
| Rate for Payer: Aetna Medicare Advantage |
$52.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.92
|
| Rate for Payer: Cigna Commercial |
$88.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.42
|
|
|
SCREW CTR-DRV 2.7x22mm
|
Facility
|
IP
|
$183.25
|
|
| Hospital Charge Code |
270610986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.49 |
| Max. Negotiated Rate |
$44.35 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.49
|
|
|
SCREW CTR-DRV 2.7x22mm
|
Facility
|
OP
|
$183.25
|
|
| Hospital Charge Code |
270610986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.49 |
| Max. Negotiated Rate |
$91.62 |
| Rate for Payer: Aetna Commercial |
$54.98
|
| Rate for Payer: Aetna Medicare Advantage |
$54.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.73
|
| Rate for Payer: Cigna Commercial |
$91.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.49
|
|
|
SCREW CTR-DRV 2.7x24mm
|
Facility
|
OP
|
$188.85
|
|
| Hospital Charge Code |
270610987
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$94.42 |
| Rate for Payer: Aetna Commercial |
$56.66
|
| Rate for Payer: Aetna Medicare Advantage |
$56.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.16
|
| Rate for Payer: Cigna Commercial |
$94.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.33
|
|
|
SCREW CTR-DRV 2.7x24mm
|
Facility
|
IP
|
$188.85
|
|
| Hospital Charge Code |
270610987
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$45.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.33
|
|
|
SCREW CTR-DRV 2.7x26mm
|
Facility
|
OP
|
$198.45
|
|
| Hospital Charge Code |
270610988
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$99.22 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare Advantage |
$59.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$39.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.60
|
| Rate for Payer: Cigna Commercial |
$99.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.77
|
|
|
SCREW CTR-DRV 2.7x26mm
|
Facility
|
IP
|
$198.45
|
|
| Hospital Charge Code |
270610988
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$39.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.77
|
|
|
SCREW CTR-DRV 2.7x28mm
|
Facility
|
OP
|
$205.65
|
|
| Hospital Charge Code |
270610989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.85 |
| Max. Negotiated Rate |
$102.83 |
| Rate for Payer: Aetna Commercial |
$61.70
|
| Rate for Payer: Aetna Medicare Advantage |
$61.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.44
|
| Rate for Payer: Cigna Commercial |
$102.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
|
|
SCREW CTR-DRV 2.7x28mm
|
Facility
|
IP
|
$205.65
|
|
| Hospital Charge Code |
270610989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.85 |
| Max. Negotiated Rate |
$49.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
|
|
SCREW CTR-DRV 2.7x30mm
|
Facility
|
OP
|
$211.25
|
|
| Hospital Charge Code |
270610990
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.69 |
| Max. Negotiated Rate |
$105.62 |
| Rate for Payer: Aetna Commercial |
$63.38
|
| Rate for Payer: Aetna Medicare Advantage |
$63.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.87
|
| Rate for Payer: Cigna Commercial |
$105.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.69
|
|
|
SCREW CTR-DRV 2.7x30mm
|
Facility
|
IP
|
$211.25
|
|
| Hospital Charge Code |
270610990
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.69 |
| Max. Negotiated Rate |
$51.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.69
|
|
|
SCREW CTR-DRV 2.7x6mm
|
Facility
|
IP
|
$151.25
|
|
| Hospital Charge Code |
270610978
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.69 |
| Max. Negotiated Rate |
$36.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.69
|
|
|
SCREW CTR-DRV 2.7x6mm
|
Facility
|
OP
|
$151.25
|
|
| Hospital Charge Code |
270610978
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.69 |
| Max. Negotiated Rate |
$75.62 |
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna Medicare Advantage |
$45.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.57
|
| Rate for Payer: Cigna Commercial |
$75.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.69
|
|
|
SCREW CTR-DRV 2.7x8mm
|
Facility
|
IP
|
$151.25
|
|
| Hospital Charge Code |
270610979
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.69 |
| Max. Negotiated Rate |
$36.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.69
|
|
|
SCREW CTR-DRV 2.7x8mm
|
Facility
|
OP
|
$151.25
|
|
| Hospital Charge Code |
270610979
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.69 |
| Max. Negotiated Rate |
$75.62 |
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna Medicare Advantage |
$45.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.57
|
| Rate for Payer: Cigna Commercial |
$75.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.69
|
|
|
SCREW CTR-DRV 2x11mm 01-9481
|
Facility
|
IP
|
$114.45
|
|
| Hospital Charge Code |
270610964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.17 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.17
|
|
|
SCREW CTR-DRV 2x11mm 01-9481
|
Facility
|
OP
|
$114.45
|
|
| Hospital Charge Code |
270610964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.17 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Aetna Commercial |
$34.34
|
| Rate for Payer: Aetna Medicare Advantage |
$34.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.18
|
| Rate for Payer: Cigna Commercial |
$57.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.17
|
|
|
SCREW CTR-DRV 2x13mm 01-9483
|
Facility
|
IP
|
$107.25
|
|
| Hospital Charge Code |
270610965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$25.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.09
|
|
|
SCREW CTR-DRV 2x13mm 01-9483
|
Facility
|
OP
|
$107.25
|
|
| Hospital Charge Code |
270610965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$53.62 |
| Rate for Payer: Aetna Commercial |
$32.17
|
| Rate for Payer: Aetna Medicare Advantage |
$32.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.35
|
| Rate for Payer: Cigna Commercial |
$53.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.09
|
|
|
SCREW CTR-DRV 2x19mm
|
Facility
|
IP
|
$116.85
|
|
| Hospital Charge Code |
270610969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.53 |
| Max. Negotiated Rate |
$28.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.53
|
|
|
SCREW CTR-DRV 2x19mm
|
Facility
|
OP
|
$116.85
|
|
| Hospital Charge Code |
270610969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.53 |
| Max. Negotiated Rate |
$58.42 |
| Rate for Payer: Aetna Commercial |
$35.05
|
| Rate for Payer: Aetna Medicare Advantage |
$35.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.80
|
| Rate for Payer: Cigna Commercial |
$58.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.53
|
|
|
SCREW CTR-DRV 2x4mm
|
Facility
|
OP
|
$96.85
|
|
| Hospital Charge Code |
270610960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$48.42 |
| Rate for Payer: Aetna Commercial |
$29.05
|
| Rate for Payer: Aetna Medicare Advantage |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.70
|
| Rate for Payer: Cigna Commercial |
$48.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
|