|
SCREW SYN CANC TL 16 7 130MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604953
|
|
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 TL 16 7 130MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604953
|
|
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 TL 16 7 135MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604954
|
|
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 TL 16 7 135MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604954
|
|
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 TL 16 7 140MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604955
|
|
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 TL 16 7 140MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604955
|
|
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 TL 16 7 145MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604956
|
|
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 TL 16 7 145MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604956
|
|
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 TL 16 7 150MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604957
|
|
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 TL 16 7 150MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604957
|
|
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 TL 16 7.3 105MM
|
Facility
|
OP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.54 |
| Max. Negotiated Rate |
$548.48 |
| Rate for Payer: Aetna Commercial |
$329.08
|
| Rate for Payer: Aetna Medicare Advantage |
$329.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.72
|
| Rate for Payer: Cigna Commercial |
$548.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
|
|
SCREW SYN CANC TL 16 7.3 105MM
|
Facility
|
IP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.54 |
| Max. Negotiated Rate |
$265.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
|
|
SCREW SYN CANC TL 16 7.3 115MM
|
Facility
|
OP
|
$1,066.45
|
|
| Hospital Charge Code |
270605036
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$159.97 |
| Max. Negotiated Rate |
$533.23 |
| Rate for Payer: Aetna Commercial |
$319.94
|
| Rate for Payer: Aetna Medicare Advantage |
$319.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$271.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$271.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$213.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$271.94
|
| Rate for Payer: Cigna Commercial |
$533.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$258.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$159.97
|
|
|
SCREW SYN CANC TL 16 7.3 115MM
|
Facility
|
IP
|
$1,066.45
|
|
| Hospital Charge Code |
270605036
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$159.97 |
| Max. Negotiated Rate |
$258.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$213.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$258.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$159.97
|
|
|
SCREW SYN CANC TL 16 7.3 55MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605024
|
|
Hospital Revenue Code
|
274
|
| 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 TL 16 7.3 55MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605024
|
|
Hospital Revenue Code
|
274
|
| 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 TL 16 7 35MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604934
|
|
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 TL 16 7 35MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604934
|
|
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 TL 16 7.3 65MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270605026
|
|
Hospital Revenue Code
|
274
|
| 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 TL 16 7.3 65MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270605026
|
|
Hospital Revenue Code
|
274
|
| 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 TL 16 7 55MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604938
|
|
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 TL 16 7 55MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604938
|
|
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 TL 16 7 75MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604942
|
|
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 TL 16 7 75MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604942
|
|
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 TL 16 7 85MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604944
|
|
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
|
|