|
SCREW DHS COMPRES 280.99
|
Facility
|
IP
|
$159.25
|
|
| Hospital Charge Code |
270603801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.89 |
| Max. Negotiated Rate |
$38.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.89
|
|
|
SCREW DHS/DCS 90mm
|
Facility
|
OP
|
$1,611.00
|
|
| Hospital Charge Code |
270671817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.65 |
| Max. Negotiated Rate |
$805.50 |
| Rate for Payer: Aetna Commercial |
$483.30
|
| Rate for Payer: Aetna Medicare Advantage |
$483.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$410.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$410.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$322.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$410.81
|
| Rate for Payer: Cigna Commercial |
$805.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$389.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.65
|
|
|
SCREW DHS/DCS 90mm
|
Facility
|
IP
|
$1,611.00
|
|
| Hospital Charge Code |
270671817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.65 |
| Max. Negotiated Rate |
$389.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$322.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$389.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.65
|
|
|
SCREW DHS LAG 12.7 105 280.05
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 105 280.05
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 110 280.10
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 110 280.10
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 115 280.15
|
Facility
|
OP
|
$701.65
|
|
| Hospital Charge Code |
270603770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.25 |
| Max. Negotiated Rate |
$350.82 |
| Rate for Payer: Aetna Commercial |
$210.50
|
| Rate for Payer: Aetna Medicare Advantage |
$210.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.92
|
| Rate for Payer: Cigna Commercial |
$350.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.25
|
|
|
SCREW DHS LAG 12.7 115 280.15
|
Facility
|
IP
|
$701.65
|
|
| Hospital Charge Code |
270603770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.25 |
| Max. Negotiated Rate |
$169.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.25
|
|
|
SCREW DHS LAG 12.7 120 280.20
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603771
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 120 280.20
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603771
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 125 280.25
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603772
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 125 280.25
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603772
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 125 280525*
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
270603796
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
SCREW DHS LAG 12.7 125 280525*
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
270603796
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$127.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$105.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
SCREW DHS LAG 12.7 130 280.30
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 130 280.30
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 135 280.35
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 135 280.35
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 140 280.40
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 140 280.40
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 145 280.45
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 145 280.45
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 50 280.50
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
270603756
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$293.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|
|
SCREW DHS LAG 12.7 50 280.50
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
270603756
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$363.60
|
| Rate for Payer: Aetna Medicare Advantage |
$363.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$309.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$309.06
|
| Rate for Payer: Cigna Commercial |
$606.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.80
|
|