|
SCREW NON LOCKING 4.5x26MM
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$131.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 4.5x26MM
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 4.5X30MM
|
Facility
|
OP
|
$305.00
|
|
| Hospital Charge Code |
270670426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5X30MM
|
Facility
|
IP
|
$305.00
|
|
| Hospital Charge Code |
270670426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$73.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON-LOCKING 4.5x38mm
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON-LOCKING 4.5x38mm
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$73.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5x40MM
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$131.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 4.5x40MM
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON-LOCKING 4.5x44mm
|
Facility
|
IP
|
$305.00
|
|
| Hospital Charge Code |
270671126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$73.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON-LOCKING 4.5x44mm
|
Facility
|
OP
|
$305.00
|
|
| Hospital Charge Code |
270671126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5x45MM
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683644
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$131.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 4.5x45MM
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683644
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 4.5x50MM
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$131.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 4.5x50MM
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON-LOCKING 4.5x65mm
|
Facility
|
IP
|
$305.00
|
|
| Hospital Charge Code |
270671125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$73.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON-LOCKING 4.5x65mm
|
Facility
|
OP
|
$305.00
|
|
| Hospital Charge Code |
270671125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5X80MM
|
Facility
|
OP
|
$305.00
|
|
| Hospital Charge Code |
270670425
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5X80MM
|
Facility
|
IP
|
$305.00
|
|
| Hospital Charge Code |
270670425
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$73.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5X85MM
|
Facility
|
IP
|
$305.00
|
|
| Hospital Charge Code |
270670424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$73.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 4.5X85MM
|
Facility
|
OP
|
$305.00
|
|
| Hospital Charge Code |
270670424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
SCREW NON LOCKING 5.5x40MM
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 5.5x40MM
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$131.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 5.5x60MM
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$131.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NON LOCKING 5.5x60MM
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
SCREW NONLOCKING 7.3X80 222646
|
Facility
|
OP
|
$858.15
|
|
| Hospital Charge Code |
270630782
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.72 |
| Max. Negotiated Rate |
$429.07 |
| Rate for Payer: Aetna Commercial |
$257.44
|
| Rate for Payer: Aetna Medicare Advantage |
$257.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$218.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$218.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$218.83
|
| Rate for Payer: Cigna Commercial |
$429.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$207.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.72
|
|