|
SCREW SYN CANC FT 7 40
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604984
|
|
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 40
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604984
|
|
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 45
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604985
|
|
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 45
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604985
|
|
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 50
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604986
|
|
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 50
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604986
|
|
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 55
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604987
|
|
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 55
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604987
|
|
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 60
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604988
|
|
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 60
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604988
|
|
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 65
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604989
|
|
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 65
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604989
|
|
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 70
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604990
|
|
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 70
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604990
|
|
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 75
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604994
|
|
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 75
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604994
|
|
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 80
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604995
|
|
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 80
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604995
|
|
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 85
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604996
|
|
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 85
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604996
|
|
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 90
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604997
|
|
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 90
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604997
|
|
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 95
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604998
|
|
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 95
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604998
|
|
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 PT 4.0 95
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$23.05
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|