|
SCREW SYN CANC FT 4.0 95
|
Facility
|
OP
|
$775.25
|
|
| Hospital Charge Code |
270604257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.29 |
| Max. Negotiated Rate |
$387.62 |
| Rate for Payer: Aetna Commercial |
$232.57
|
| Rate for Payer: Aetna Medicare Advantage |
$232.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$197.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$197.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$155.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$197.69
|
| Rate for Payer: Cigna Commercial |
$387.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$187.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.29
|
|
|
SCREW SYN CANC FT 7 100
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 100
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 105
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 105
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 110
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 110
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 115
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 115
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 120
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 120
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 125
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605004
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 125
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605004
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 130
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 130
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 20
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 20
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 25
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 25
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 30
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604982
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 30
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604982
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 35
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604983
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 35
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604983
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$306.25
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7.3 65
|
Facility
|
IP
|
$1,360.00
|
|
| Hospital Charge Code |
270605078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$329.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.00
|
|
|
SCREW SYN CANC FT 7.3 65
|
Facility
|
OP
|
$1,360.00
|
|
| Hospital Charge Code |
270605078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna Commercial |
$408.00
|
| Rate for Payer: Aetna Medicare Advantage |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$346.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$346.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$346.80
|
| Rate for Payer: Cigna Commercial |
$680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.00
|
|