|
SCREW SYN CORT TT 3.5 75 40475
|
Facility
|
IP
|
$71.25
|
|
| Hospital Charge Code |
270603180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$17.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CORT TTN 1.5/7MM
|
Facility
|
IP
|
$192.85
|
|
| Hospital Charge Code |
270603949
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.93 |
| Max. Negotiated Rate |
$46.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.93
|
|
|
SCREW SYN CORT TTN 1.5/7MM
|
Facility
|
OP
|
$192.85
|
|
| Hospital Charge Code |
270603949
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.93 |
| Max. Negotiated Rate |
$96.42 |
| Rate for Payer: Aetna Commercial |
$57.85
|
| Rate for Payer: Aetna Medicare Advantage |
$57.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.18
|
| Rate for Payer: Cigna Commercial |
$96.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.93
|
|
|
SCREW SYN CORT TTN 2.7/20MM
|
Facility
|
OP
|
$207.25
|
|
| Hospital Charge Code |
270603052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Aetna Commercial |
$62.17
|
| Rate for Payer: Aetna Medicare Advantage |
$62.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.85
|
| Rate for Payer: Cigna Commercial |
$103.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.09
|
|
|
SCREW SYN CORT TTN 2.7/20MM
|
Facility
|
IP
|
$207.25
|
|
| Hospital Charge Code |
270603052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$50.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.09
|
|
|
SCREW SYN CORT TTN 2.7/22MM
|
Facility
|
OP
|
$207.25
|
|
| Hospital Charge Code |
270603053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Aetna Commercial |
$62.17
|
| Rate for Payer: Aetna Medicare Advantage |
$62.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.85
|
| Rate for Payer: Cigna Commercial |
$103.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.09
|
|
|
SCREW SYN CORT TTN 2.7/22MM
|
Facility
|
IP
|
$207.25
|
|
| Hospital Charge Code |
270603053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$50.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.09
|
|
|
SCREW SYN CORT TTN 2.7/24MM
|
Facility
|
OP
|
$207.25
|
|
| Hospital Charge Code |
270603054
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Aetna Commercial |
$62.17
|
| Rate for Payer: Aetna Medicare Advantage |
$62.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.85
|
| Rate for Payer: Cigna Commercial |
$103.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.09
|
|
|
SCREW SYN CORT TTN 2.7/24MM
|
Facility
|
IP
|
$207.25
|
|
| Hospital Charge Code |
270603054
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$50.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.09
|
|
|
SCREW SYN CORT TTN 3.5/100MM
|
Facility
|
IP
|
$71.25
|
|
| Hospital Charge Code |
270603185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$17.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CORT TTN 3.5/100MM
|
Facility
|
OP
|
$71.25
|
|
| Hospital Charge Code |
270603185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$35.62 |
| Rate for Payer: Aetna Commercial |
$21.38
|
| Rate for Payer: Aetna Medicare Advantage |
$21.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.17
|
| Rate for Payer: Cigna Commercial |
$35.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CORT TTN 3.5/105MM
|
Facility
|
OP
|
$96.85
|
|
| Hospital Charge Code |
270603186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$48.42 |
| Rate for Payer: Aetna Commercial |
$29.05
|
| Rate for Payer: Aetna Medicare Advantage |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.70
|
| Rate for Payer: Cigna Commercial |
$48.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
|
|
SCREW SYN CORT TTN 3.5/105MM
|
Facility
|
IP
|
$96.85
|
|
| Hospital Charge Code |
270603186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$23.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
|
|
SCREW SYN CORT TTN 3.5/110MM
|
Facility
|
IP
|
$71.25
|
|
| Hospital Charge Code |
270603187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$17.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CORT TTN 3.5/110MM
|
Facility
|
OP
|
$71.25
|
|
| Hospital Charge Code |
270603187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$35.62 |
| Rate for Payer: Aetna Commercial |
$21.38
|
| Rate for Payer: Aetna Medicare Advantage |
$21.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.17
|
| Rate for Payer: Cigna Commercial |
$35.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CORT TTN 3.5/12MM
|
Facility
|
OP
|
$124.85
|
|
| Hospital Charge Code |
270603078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare Advantage |
$37.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.84
|
| Rate for Payer: Cigna Commercial |
$62.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|
|
SCREW SYN CORT TTN 3.5/12MM
|
Facility
|
IP
|
$124.85
|
|
| Hospital Charge Code |
270603078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$30.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|
|
SCREW SYN CORT TTN 3.5/40MM
|
Facility
|
IP
|
$93.65
|
|
| Hospital Charge Code |
270603193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$22.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.05
|
|
|
SCREW SYN CORT TTN 3.5/40MM
|
Facility
|
OP
|
$93.65
|
|
| Hospital Charge Code |
270603193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$46.83 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare Advantage |
$28.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.88
|
| Rate for Payer: Cigna Commercial |
$46.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.05
|
|
|
SCREW SYN CORT TTN 3.5/45MM
|
Facility
|
OP
|
$93.65
|
|
| Hospital Charge Code |
270603194
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$46.83 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare Advantage |
$28.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.88
|
| Rate for Payer: Cigna Commercial |
$46.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.05
|
|
|
SCREW SYN CORT TTN 3.5/45MM
|
Facility
|
IP
|
$93.65
|
|
| Hospital Charge Code |
270603194
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$22.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.05
|
|
|
SCREW SYN CORT TTN 3.5/50MM
|
Facility
|
IP
|
$93.65
|
|
| Hospital Charge Code |
270603195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$22.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.05
|
|
|
SCREW SYN CORT TTN 3.5/50MM
|
Facility
|
OP
|
$93.65
|
|
| Hospital Charge Code |
270603195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$46.83 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare Advantage |
$28.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.88
|
| Rate for Payer: Cigna Commercial |
$46.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.05
|
|
|
SCREW SYN CORT TTN 3.5/55MM
|
Facility
|
OP
|
$71.25
|
|
| Hospital Charge Code |
270603176
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$35.62 |
| Rate for Payer: Aetna Commercial |
$21.38
|
| Rate for Payer: Aetna Medicare Advantage |
$21.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.17
|
| Rate for Payer: Cigna Commercial |
$35.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CORT TTN 3.5/55MM
|
Facility
|
IP
|
$71.25
|
|
| Hospital Charge Code |
270603176
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$17.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|