|
SCREW LOCKING 2.3x22mm
|
Facility
|
OP
|
$521.67
|
|
| Hospital Charge Code |
270659993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.25 |
| Max. Negotiated Rate |
$260.83 |
| Rate for Payer: Aetna Commercial |
$156.50
|
| Rate for Payer: Aetna Medicare Advantage |
$156.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$104.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.03
|
| Rate for Payer: Cigna Commercial |
$260.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.25
|
|
|
SCREW LOCKING 2.3x22mm
|
Facility
|
IP
|
$521.67
|
|
| Hospital Charge Code |
270659993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.25 |
| Max. Negotiated Rate |
$126.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$104.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.25
|
|
|
SCREW LOCKING 2.3x26mm
|
Facility
|
OP
|
$520.00
|
|
| Hospital Charge Code |
270656026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$260.00 |
| Rate for Payer: Aetna Commercial |
$156.00
|
| Rate for Payer: Aetna Medicare Advantage |
$156.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$104.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.60
|
| Rate for Payer: Cigna Commercial |
$260.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.00
|
|
|
SCREW LOCKING 2.3x26mm
|
Facility
|
IP
|
$520.00
|
|
| Hospital Charge Code |
270656026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$125.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$104.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.00
|
|
|
SCREW LOCKING 2.4 X 10 MM
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4 X 10 MM
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$210.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4X10MM
|
Facility
|
OP
|
$1,050.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Aetna Commercial |
$315.00
|
| Rate for Payer: Aetna Medicare Advantage |
$315.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$267.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$267.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$267.75
|
| Rate for Payer: Cigna Commercial |
$525.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$254.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.50
|
|
|
SCREW LOCKING 2.4X10MM
|
Facility
|
IP
|
$1,050.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$254.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$254.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.50
|
|
|
SCREW LOCKING 2.4 X 12
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687437
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$210.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4 X 12
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687437
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4 X 12 MM
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$210.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4 X 12 MM
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4X14 MM
|
Facility
|
IP
|
$1,146.60
|
|
| Hospital Charge Code |
270703509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$277.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X14 MM
|
Facility
|
OP
|
$1,146.60
|
|
| Hospital Charge Code |
270703509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Aetna Commercial |
$343.98
|
| Rate for Payer: Aetna Medicare Advantage |
$343.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$292.38
|
| Rate for Payer: Cigna Commercial |
$573.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X16 MM
|
Facility
|
OP
|
$1,146.60
|
|
| Hospital Charge Code |
270703510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Aetna Commercial |
$343.98
|
| Rate for Payer: Aetna Medicare Advantage |
$343.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$292.38
|
| Rate for Payer: Cigna Commercial |
$573.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X16 MM
|
Facility
|
IP
|
$1,146.60
|
|
| Hospital Charge Code |
270703510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$277.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X18 MM
|
Facility
|
IP
|
$1,146.60
|
|
| Hospital Charge Code |
270703511
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$277.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X18 MM
|
Facility
|
OP
|
$1,146.60
|
|
| Hospital Charge Code |
270703511
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Aetna Commercial |
$343.98
|
| Rate for Payer: Aetna Medicare Advantage |
$343.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$292.38
|
| Rate for Payer: Cigna Commercial |
$573.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X18MM
|
Facility
|
IP
|
$1,323.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270706208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.53 |
| Max. Negotiated Rate |
$320.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$264.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$320.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.53
|
|
|
SCREW LOCKING 2.4X18MM
|
Facility
|
OP
|
$1,323.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270706208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.53 |
| Max. Negotiated Rate |
$661.77 |
| Rate for Payer: Aetna Commercial |
$397.06
|
| Rate for Payer: Aetna Medicare Advantage |
$397.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$337.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$337.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$264.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$337.51
|
| Rate for Payer: Cigna Commercial |
$661.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$320.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.53
|
|
|
SCREW LOCKING 2.4 X 20 MM
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690537
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4 X 20 MM
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690537
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$210.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
SCREW LOCKING 2.4X20 MM
|
Facility
|
OP
|
$1,146.60
|
|
| Hospital Charge Code |
270703512
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Aetna Commercial |
$343.98
|
| Rate for Payer: Aetna Medicare Advantage |
$343.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$292.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$292.38
|
| Rate for Payer: Cigna Commercial |
$573.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X20 MM
|
Facility
|
IP
|
$1,146.60
|
|
| Hospital Charge Code |
270703512
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$277.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$229.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.99
|
|
|
SCREW LOCKING 2.4X24
|
Facility
|
IP
|
$1,034.00
|
|
| Hospital Charge Code |
270702593
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$250.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$206.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$155.10
|
|