|
SCREW VA LOCKING 2.4mm X 16mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 18mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 18mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 24mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 24mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4mm X 26mm
|
Facility
|
OP
|
$577.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645537
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$288.93 |
| Rate for Payer: Aetna Commercial |
$173.35
|
| Rate for Payer: Aetna Medicare Advantage |
$173.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$147.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$147.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$115.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$147.35
|
| Rate for Payer: Cigna Commercial |
$288.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.68
|
|
|
SCREW VA LOCKING 2.4mm X 26mm
|
Facility
|
IP
|
$577.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645537
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$139.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$115.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.68
|
|
|
SCREW VA LOCKING 2.4x10mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x10mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x11mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685322
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x11mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685322
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x12mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x12mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x13mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x13mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x14mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645539
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x14mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645539
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x20MM
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270646344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x20MM
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270646344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x22MM
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645540
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x22MM
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645540
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x28mm
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270646343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x28mm
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270646343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x8MM
|
Facility
|
IP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|
|
SCREW VA LOCKING 2.4x8MM
|
Facility
|
OP
|
$595.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$178.56
|
| Rate for Payer: Aetna Medicare Advantage |
$178.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.78
|
| Rate for Payer: Cigna Commercial |
$297.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.28
|
|