|
SCREW SYN CORT 2.7 16MM 202.16
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 16MM 202.16
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 22MM 202.22
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604191
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 22MM 202.22
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604191
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 24MM 202.24
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 24MM 202.24
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 26MM 202.26
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604194
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 26MM 202.26
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604194
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 28MM 202.28
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 28MM 202.28
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 30MM 202.30
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 30MM 202.30
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 32MM 202.32
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 32MM 202.32
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 34MM 202.34
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604198
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 34MM 202.34
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604198
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 36MM 202.36
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 36MM 202.36
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 38MM 202.38
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 38MM 202.38
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 40MM 202.40
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 40MM 202.40
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 8MM 202.08
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$19.70
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 8MM 202.08
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 3.5 100 204100
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270604229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$50.42 |
| Rate for Payer: Aetna Commercial |
$30.25
|
| Rate for Payer: Aetna Medicare Advantage |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.72
|
| Rate for Payer: Cigna Commercial |
$50.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
|