|
SCREW SYN CORT 4.5 14MM 214.14
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5 16MM 214.16
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5 16MM 214.16
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270603630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5/18MM 214.18
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270603632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5/18MM 214.18
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5/20MM 214.20
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603723
|
|
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 4.5/20MM 214.20
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603723
|
|
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 4.5/22MM 214.22
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603724
|
|
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 4.5/22MM 214.22
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603724
|
|
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 4.5/24MM 214.24
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603725
|
|
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 4.5/24MM 214.24
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603725
|
|
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 4.5/26MM 214.26
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603726
|
|
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 4.5/26MM 214.26
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603726
|
|
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 4.5/28MM 214.28
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603727
|
|
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 4.5/28MM 214.28
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603727
|
|
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 4.5/30MM 214.30
|
Facility
|
OP
|
$91.25
|
|
| Hospital Charge Code |
270603608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$45.62 |
| Rate for Payer: Aetna Commercial |
$27.38
|
| Rate for Payer: Aetna Medicare Advantage |
$27.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.27
|
| Rate for Payer: Cigna Commercial |
$45.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.69
|
|
|
SCREW SYN CORT 4.5/30MM 214.30
|
Facility
|
IP
|
$91.25
|
|
| Hospital Charge Code |
270603608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.69
|
|
|
SCREW SYN CORT 4.5/30MM 214.30
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603728
|
|
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 4.5/30MM 214.30
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603728
|
|
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 4.5/32MM 214.32
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603729
|
|
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 4.5/32MM 214.32
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603729
|
|
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 4.5/34MM 214.34
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5/34MM 214.34
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270603730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 4.5/38MM 214.38
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603732
|
|
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 4.5/38MM 214.38
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603732
|
|
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
|
|