|
SCREW SYN CANC TL 32 7 45MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604958
|
|
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 32 7 45MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604958
|
|
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 32 7 50MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604959
|
|
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 32 7 50MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604959
|
|
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 32 7 55MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604960
|
|
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 32 7 55MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604960
|
|
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 32 7 60MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604961
|
|
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 32 7 60MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604961
|
|
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 32 7 65MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604962
|
|
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 32 7 65MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604962
|
|
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 32 7 70MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604963
|
|
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 32 7 70MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604963
|
|
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 32 7 75MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604964
|
|
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 32 7 75MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604964
|
|
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 32 7 80MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604965
|
|
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 32 7 80MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604965
|
|
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 32 7 90MM
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604967
|
|
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 32 7 90MM
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604967
|
|
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 TT 4.0 10
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270603311
|
|
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
|
|
|
SCREW SYN CANC TT 4.0 10
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270603196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC TT 4.0 10
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270603311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC TT 4.0 10
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270603196
|
|
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
|
|
|
SCREW SYN CANC TT 4.0 12
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270603312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC TT 4.0 12
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270603197
|
|
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
|
|
|
SCREW SYN CANC TT 4.0 12
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270603197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|