|
SCREW HEADED 2.0x12MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662463
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x14MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x14MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x16MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662470
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x16MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662470
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x24MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270667122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x24MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270667122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.4X 10MM
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$235.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
SCREW HEADED 2.4X 10MM
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
SCREW HEADED 2.4X 8MM
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679821
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$235.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
SCREW HEADED 2.4X 8MM
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679821
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
SCREW HEADED 2.5x16MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.5x16MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 3.0x40MM
|
Facility
|
OP
|
$825.00
|
|
| Hospital Charge Code |
270667118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.75 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Aetna Commercial |
$247.50
|
| Rate for Payer: Aetna Medicare Advantage |
$247.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$210.38
|
| Rate for Payer: Cigna Commercial |
$412.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.75
|
|
|
SCREW HEADED 3.0x40MM
|
Facility
|
IP
|
$825.00
|
|
| Hospital Charge Code |
270667118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.75 |
| Max. Negotiated Rate |
$199.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$165.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.75
|
|
|
SCREW HEADED 3.5MMX38MM
|
Facility
|
OP
|
$1,055.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.25 |
| Max. Negotiated Rate |
$527.50 |
| Rate for Payer: Aetna Commercial |
$316.50
|
| Rate for Payer: Aetna Medicare Advantage |
$316.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$269.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$269.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$211.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$269.02
|
| Rate for Payer: Cigna Commercial |
$527.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$255.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.25
|
|
|
SCREW HEADED 3.5MMX38MM
|
Facility
|
IP
|
$1,055.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.25 |
| Max. Negotiated Rate |
$255.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$211.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$255.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.25
|
|
|
SCREW HEADED 3.5x32MM
|
Facility
|
OP
|
$855.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.25 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Aetna Commercial |
$256.50
|
| Rate for Payer: Aetna Medicare Advantage |
$256.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$218.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$218.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$218.03
|
| Rate for Payer: Cigna Commercial |
$427.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$206.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.25
|
|
|
SCREW HEADED 3.5x32MM
|
Facility
|
IP
|
$855.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.25 |
| Max. Negotiated Rate |
$206.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$206.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.25
|
|
|
SCREW HEADED 3.5x40MM
|
Facility
|
IP
|
$855.00
|
|
| Hospital Charge Code |
270662462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.25 |
| Max. Negotiated Rate |
$206.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$206.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.25
|
|
|
SCREW HEADED 3.5x40MM
|
Facility
|
OP
|
$855.00
|
|
| Hospital Charge Code |
270662462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.25 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Aetna Commercial |
$256.50
|
| Rate for Payer: Aetna Medicare Advantage |
$256.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$218.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$218.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$218.03
|
| Rate for Payer: Cigna Commercial |
$427.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$206.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.25
|
|
|
SCREW HEADED 4.0x32MM
|
Facility
|
IP
|
$1,220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$295.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$244.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.00
|
|
|
SCREW HEADED 4.0x32MM
|
Facility
|
OP
|
$1,220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Aetna Commercial |
$366.00
|
| Rate for Payer: Aetna Medicare Advantage |
$366.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$311.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$311.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$244.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$311.10
|
| Rate for Payer: Cigna Commercial |
$610.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.00
|
|
|
SCREW HEADED 4.0 X 38 MM
|
Facility
|
OP
|
$907.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701211
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.12 |
| Max. Negotiated Rate |
$453.75 |
| Rate for Payer: Aetna Commercial |
$272.25
|
| Rate for Payer: Aetna Medicare Advantage |
$272.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$231.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$231.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$231.41
|
| Rate for Payer: Cigna Commercial |
$453.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.12
|
|
|
SCREW HEADED 4.0 X 38 MM
|
Facility
|
IP
|
$907.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701211
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.12 |
| Max. Negotiated Rate |
$219.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.12
|
|