|
SCREW ZIM COMP HX 1 1/2
|
Facility
|
IP
|
$183.85
|
|
| Hospital Charge Code |
270606036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.58 |
| Max. Negotiated Rate |
$44.49 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.58
|
|
|
SCREW ZIM COMP HX 1 1/2
|
Facility
|
OP
|
$183.85
|
|
| Hospital Charge Code |
270606036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.58 |
| Max. Negotiated Rate |
$91.92 |
| Rate for Payer: Aetna Commercial |
$55.16
|
| Rate for Payer: Aetna Medicare Advantage |
$55.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.88
|
| Rate for Payer: Cigna Commercial |
$91.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.58
|
|
|
SCREW ZIM COMP HX 1 1/4
|
Facility
|
OP
|
$198.45
|
|
| Hospital Charge Code |
270601415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$99.22 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare Advantage |
$59.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$39.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.60
|
| Rate for Payer: Cigna Commercial |
$99.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.77
|
|
|
SCREW ZIM COMP HX 1 1/4
|
Facility
|
IP
|
$198.45
|
|
| Hospital Charge Code |
270601415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$39.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.77
|
|
|
SCREW ZIM CORT 1.5 12 235015
|
Facility
|
OP
|
$40.85
|
|
| Hospital Charge Code |
270610104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$20.43 |
| Rate for Payer: Aetna Commercial |
$12.26
|
| Rate for Payer: Aetna Medicare Advantage |
$12.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.42
|
| Rate for Payer: Cigna Commercial |
$20.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.13
|
|
|
SCREW ZIM CORT 1.5 12 235015
|
Facility
|
IP
|
$40.85
|
|
| Hospital Charge Code |
270610104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$9.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.13
|
|
|
SCREW ZIM CORT 1.5 15 235016
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270602001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 1.5 15 235016
|
Facility
|
OP
|
$54.45
|
|
| Hospital Charge Code |
270602001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$27.23 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Medicare Advantage |
$16.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.88
|
| Rate for Payer: Cigna Commercial |
$27.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.0 18 232019
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270608058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.0 18 232019
|
Facility
|
OP
|
$54.45
|
|
| Hospital Charge Code |
270608058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$27.23 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Medicare Advantage |
$16.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.88
|
| Rate for Payer: Cigna Commercial |
$27.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.0 20 232020
|
Facility
|
IP
|
$306.45
|
|
| Hospital Charge Code |
270606024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.97 |
| Max. Negotiated Rate |
$74.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.97
|
|
|
SCREW ZIM CORT 2.0 20 232020
|
Facility
|
OP
|
$306.45
|
|
| Hospital Charge Code |
270606024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.97 |
| Max. Negotiated Rate |
$153.22 |
| Rate for Payer: Aetna Commercial |
$91.94
|
| Rate for Payer: Aetna Medicare Advantage |
$91.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.14
|
| Rate for Payer: Cigna Commercial |
$153.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.97
|
|
|
SCREW ZIM CORT 2.0 20 232021
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270608059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.0 20 232021
|
Facility
|
OP
|
$54.45
|
|
| Hospital Charge Code |
270608059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$27.23 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Medicare Advantage |
$16.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.88
|
| Rate for Payer: Cigna Commercial |
$27.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.0 24 232025
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270608060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.0 24 232025
|
Facility
|
OP
|
$54.45
|
|
| Hospital Charge Code |
270608060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$27.23 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Medicare Advantage |
$16.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.88
|
| Rate for Payer: Cigna Commercial |
$27.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.7 10 232411
|
Facility
|
OP
|
$54.45
|
|
| Hospital Charge Code |
270610118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$27.23 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Medicare Advantage |
$16.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.88
|
| Rate for Payer: Cigna Commercial |
$27.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.7 10 232411
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270610118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.7 12 232413
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270610120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.7 12 232413
|
Facility
|
OP
|
$54.45
|
|
| Hospital Charge Code |
270610120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$27.23 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Medicare Advantage |
$16.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.88
|
| Rate for Payer: Cigna Commercial |
$27.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|
|
SCREW ZIM CORT 2.7 16 232417
|
Facility
|
OP
|
$57.65
|
|
| Hospital Charge Code |
270610123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$28.82 |
| Rate for Payer: Aetna Commercial |
$17.30
|
| Rate for Payer: Aetna Medicare Advantage |
$17.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.70
|
| Rate for Payer: Cigna Commercial |
$28.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.65
|
|
|
SCREW ZIM CORT 2.7 16 232417
|
Facility
|
IP
|
$57.65
|
|
| Hospital Charge Code |
270610123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.65
|
|
|
SCREW ZIM CORT 2.7 8 232408
|
Facility
|
IP
|
$50.45
|
|
| Hospital Charge Code |
270606025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$12.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.57
|
|
|
SCREW ZIM CORT 2.7 8 232408
|
Facility
|
OP
|
$50.45
|
|
| Hospital Charge Code |
270606025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$25.23 |
| Rate for Payer: Aetna Commercial |
$15.13
|
| Rate for Payer: Aetna Medicare Advantage |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.86
|
| Rate for Payer: Cigna Commercial |
$25.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.57
|
|
|
SCREW ZIM CORT 3.5 10 235011
|
Facility
|
IP
|
$54.45
|
|
| Hospital Charge Code |
270607153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.17
|
|