|
SCREW NON LOCK F/THD 3.5x40MM
|
Facility
|
IP
|
$354.90
|
|
| Hospital Charge Code |
270674950
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$85.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.23
|
|
|
SCREW NON LOCK F/THD 3.5x40MM
|
Facility
|
OP
|
$354.90
|
|
| Hospital Charge Code |
270674950
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$177.45 |
| Rate for Payer: Aetna Commercial |
$106.47
|
| Rate for Payer: Aetna Medicare Advantage |
$106.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$90.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$90.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$90.50
|
| Rate for Payer: Cigna Commercial |
$177.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.23
|
|
|
SCREW NON LOCK F/THD 3.5x55MM
|
Facility
|
OP
|
$354.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674952
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$177.45 |
| Rate for Payer: Aetna Commercial |
$106.47
|
| Rate for Payer: Aetna Medicare Advantage |
$106.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$90.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$90.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$90.50
|
| Rate for Payer: Cigna Commercial |
$177.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.23
|
|
|
SCREW NON LOCK F/THD 3.5x55MM
|
Facility
|
IP
|
$354.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674952
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$85.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.23
|
|
|
SCREW NONLOCK HEXALOBE 3X16MM
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare Advantage |
$142.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$95.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121.12
|
| Rate for Payer: Cigna Commercial |
$237.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
|
|
SCREW NONLOCK HEXALOBE 3X16MM
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$114.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
|
|
SCREW NONLOCK HEXALOBE 3X20MM
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$114.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
|
|
SCREW NONLOCK HEXALOBE 3X20MM
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare Advantage |
$142.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$95.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121.12
|
| Rate for Payer: Cigna Commercial |
$237.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
|
|
SCREW NONLOCK H-LOBE 3.5X18MM
|
Facility
|
OP
|
$435.00
|
|
| Hospital Charge Code |
270669424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$217.50 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Aetna Medicare Advantage |
$130.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$110.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$110.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$110.92
|
| Rate for Payer: Cigna Commercial |
$217.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.25
|
|
|
SCREW NONLOCK H-LOBE 3.5X18MM
|
Facility
|
IP
|
$435.00
|
|
| Hospital Charge Code |
270669424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$105.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.25
|
|
|
SCREW NON-LOCKING 12MM
|
Facility
|
IP
|
$650.00
|
|
| Hospital Charge Code |
270663853
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
SCREW NON-LOCKING 12MM
|
Facility
|
OP
|
$650.00
|
|
| Hospital Charge Code |
270663853
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$195.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
SCREW NON LOCKING 16MM
|
Facility
|
OP
|
$395.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270668019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$197.50 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna Medicare Advantage |
$118.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.72
|
| Rate for Payer: Cigna Commercial |
$197.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
SCREW NON LOCKING 16MM
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270668019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$95.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
SCREW NON LOCKING 2.3X12MM
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
270669461
|
|
Hospital Revenue Code
|
278
|
| 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 NON LOCKING 2.3X12MM
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
270669461
|
|
Hospital Revenue Code
|
278
|
| 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 NON LOCKING 2.5 X 11 MM
|
Facility
|
IP
|
$925.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.82 |
| Max. Negotiated Rate |
$223.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$223.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.82
|
|
|
SCREW NON LOCKING 2.5 X 11 MM
|
Facility
|
OP
|
$925.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.82 |
| Max. Negotiated Rate |
$462.75 |
| Rate for Payer: Aetna Commercial |
$277.65
|
| Rate for Payer: Aetna Medicare Advantage |
$277.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$236.00
|
| Rate for Payer: Cigna Commercial |
$462.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$223.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.82
|
|
|
SCREW NON LOCKING 2.5 X 12 MM
|
Facility
|
OP
|
$925.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.82 |
| Max. Negotiated Rate |
$462.75 |
| Rate for Payer: Aetna Commercial |
$277.65
|
| Rate for Payer: Aetna Medicare Advantage |
$277.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$236.00
|
| Rate for Payer: Cigna Commercial |
$462.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$223.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.82
|
|
|
SCREW NON LOCKING 2.5 X 12 MM
|
Facility
|
IP
|
$925.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.82 |
| Max. Negotiated Rate |
$223.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$223.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.82
|
|
|
SCREW NON LOCKING 2.5 X 16 MM
|
Facility
|
IP
|
$570.00
|
|
| Hospital Charge Code |
270667008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$137.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
|
|
SCREW NON LOCKING 2.5 X 16 MM
|
Facility
|
OP
|
$570.00
|
|
| Hospital Charge Code |
270667008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare Advantage |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$145.35
|
| Rate for Payer: Cigna Commercial |
$285.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
|
|
SCREW NON LOCKING 2.7 10 MM
|
Facility
|
IP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$393.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
|
|
SCREW NON LOCKING 2.7 10 MM
|
Facility
|
OP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$812.50 |
| Rate for Payer: Aetna Commercial |
$487.50
|
| Rate for Payer: Aetna Medicare Advantage |
$487.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$414.38
|
| Rate for Payer: Cigna Commercial |
$812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
|
|
SCREW NON LOCKING 2.7X16MM
|
Facility
|
OP
|
$1,230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693516
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.50 |
| Max. Negotiated Rate |
$615.00 |
| Rate for Payer: Aetna Commercial |
$369.00
|
| Rate for Payer: Aetna Medicare Advantage |
$369.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$313.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$313.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$246.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$313.65
|
| Rate for Payer: Cigna Commercial |
$615.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$297.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$184.50
|
|