|
SCREW ZIM LAG 105MM 1181-10-45
|
Facility
|
IP
|
$877.65
|
|
| Hospital Charge Code |
270602004
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.65 |
| Max. Negotiated Rate |
$212.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$175.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.65
|
|
|
SCREW ZIM LAG 110MM 1181-01047
|
Facility
|
IP
|
$813.65
|
|
| Hospital Charge Code |
270601783
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.05 |
| Max. Negotiated Rate |
$196.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.05
|
|
|
SCREW ZIM LAG 110MM 1181-01047
|
Facility
|
OP
|
$813.65
|
|
| Hospital Charge Code |
270601783
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.05 |
| Max. Negotiated Rate |
$406.82 |
| Rate for Payer: Aetna Commercial |
$244.09
|
| Rate for Payer: Aetna Medicare Advantage |
$244.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.48
|
| Rate for Payer: Cigna Commercial |
$406.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.05
|
|
|
SCREW ZIM LAG 115MM 1181-01050
|
Facility
|
OP
|
$910.50
|
|
| Hospital Charge Code |
270601784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$455.25 |
| Rate for Payer: Aetna Commercial |
$273.15
|
| Rate for Payer: Aetna Medicare Advantage |
$273.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$232.18
|
| Rate for Payer: Cigna Commercial |
$455.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 115MM 1181-01050
|
Facility
|
IP
|
$910.50
|
|
| Hospital Charge Code |
270601784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$220.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 120MM 1181-01052
|
Facility
|
IP
|
$956.85
|
|
| Hospital Charge Code |
270610671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.53 |
| Max. Negotiated Rate |
$231.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$191.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$231.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.53
|
|
|
SCREW ZIM LAG 120MM 1181-01052
|
Facility
|
OP
|
$956.85
|
|
| Hospital Charge Code |
270610671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.53 |
| Max. Negotiated Rate |
$478.43 |
| Rate for Payer: Aetna Commercial |
$287.06
|
| Rate for Payer: Aetna Medicare Advantage |
$287.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$244.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$244.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$191.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$244.00
|
| Rate for Payer: Cigna Commercial |
$478.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$231.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.53
|
|
|
SCREW ZIM LAG 130MM 1181-01057
|
Facility
|
OP
|
$811.25
|
|
| Hospital Charge Code |
270613439
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.69 |
| Max. Negotiated Rate |
$405.62 |
| Rate for Payer: Aetna Commercial |
$243.38
|
| Rate for Payer: Aetna Medicare Advantage |
$243.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$206.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$206.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$206.87
|
| Rate for Payer: Cigna Commercial |
$405.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.69
|
|
|
SCREW ZIM LAG 130MM 1181-01057
|
Facility
|
IP
|
$811.25
|
|
| Hospital Charge Code |
270613439
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.69 |
| Max. Negotiated Rate |
$196.32 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.69
|
|
|
SCREW ZIM LAG 65MM 1181-01025
|
Facility
|
IP
|
$877.65
|
|
| Hospital Charge Code |
270601774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.65 |
| Max. Negotiated Rate |
$212.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$175.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.65
|
|
|
SCREW ZIM LAG 65MM 1181-01025
|
Facility
|
OP
|
$877.65
|
|
| Hospital Charge Code |
270601774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.65 |
| Max. Negotiated Rate |
$438.82 |
| Rate for Payer: Aetna Commercial |
$263.30
|
| Rate for Payer: Aetna Medicare Advantage |
$263.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$175.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.80
|
| Rate for Payer: Cigna Commercial |
$438.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.65
|
|
|
SCREW ZIM LAG 70MM 1181-01027
|
Facility
|
OP
|
$910.50
|
|
| Hospital Charge Code |
270601775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$455.25 |
| Rate for Payer: Aetna Commercial |
$273.15
|
| Rate for Payer: Aetna Medicare Advantage |
$273.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$232.18
|
| Rate for Payer: Cigna Commercial |
$455.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 70MM 1181-01027
|
Facility
|
IP
|
$910.50
|
|
| Hospital Charge Code |
270601775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$220.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 75MM 1181-01030
|
Facility
|
OP
|
$813.65
|
|
| Hospital Charge Code |
270601777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.05 |
| Max. Negotiated Rate |
$406.82 |
| Rate for Payer: Aetna Commercial |
$244.09
|
| Rate for Payer: Aetna Medicare Advantage |
$244.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.48
|
| Rate for Payer: Cigna Commercial |
$406.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.05
|
|
|
SCREW ZIM LAG 75MM 1181-01030
|
Facility
|
IP
|
$813.65
|
|
| Hospital Charge Code |
270601777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.05 |
| Max. Negotiated Rate |
$196.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.05
|
|
|
SCREW ZIM LAG 80MM 1181-01032
|
Facility
|
IP
|
$910.50
|
|
| Hospital Charge Code |
270601778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$220.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 80MM 1181-01032
|
Facility
|
OP
|
$910.50
|
|
| Hospital Charge Code |
270601778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$455.25 |
| Rate for Payer: Aetna Commercial |
$273.15
|
| Rate for Payer: Aetna Medicare Advantage |
$273.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$232.18
|
| Rate for Payer: Cigna Commercial |
$455.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 85MM 1181-01035
|
Facility
|
IP
|
$902.75
|
|
| Hospital Charge Code |
270601779
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.41 |
| Max. Negotiated Rate |
$218.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$218.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.41
|
|
|
SCREW ZIM LAG 85MM 1181-01035
|
Facility
|
OP
|
$902.75
|
|
| Hospital Charge Code |
270601779
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.41 |
| Max. Negotiated Rate |
$451.38 |
| Rate for Payer: Aetna Commercial |
$270.82
|
| Rate for Payer: Aetna Medicare Advantage |
$270.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$230.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$230.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$230.20
|
| Rate for Payer: Cigna Commercial |
$451.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$218.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.41
|
|
|
SCREW ZIM LAG 90MM 1181-01037
|
Facility
|
IP
|
$910.50
|
|
| Hospital Charge Code |
270601780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$220.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 90MM 1181-01037
|
Facility
|
OP
|
$910.50
|
|
| Hospital Charge Code |
270601780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.57 |
| Max. Negotiated Rate |
$455.25 |
| Rate for Payer: Aetna Commercial |
$273.15
|
| Rate for Payer: Aetna Medicare Advantage |
$273.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$232.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$182.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$232.18
|
| Rate for Payer: Cigna Commercial |
$455.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$220.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.57
|
|
|
SCREW ZIM LAG 95MM 1181-01040
|
Facility
|
IP
|
$946.90
|
|
| Hospital Charge Code |
270601781
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.03 |
| Max. Negotiated Rate |
$229.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$189.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$229.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.03
|
|
|
SCREW ZIM LAG 95MM 1181-01040
|
Facility
|
OP
|
$946.90
|
|
| Hospital Charge Code |
270601781
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.03 |
| Max. Negotiated Rate |
$473.45 |
| Rate for Payer: Aetna Commercial |
$284.07
|
| Rate for Payer: Aetna Medicare Advantage |
$284.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$241.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$241.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$189.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$241.46
|
| Rate for Payer: Cigna Commercial |
$473.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$229.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.03
|
|
|
SCREW ZIM LAG SHT 11810522
|
Facility
|
IP
|
$1,142.45
|
|
| Hospital Charge Code |
270601441
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.37 |
| Max. Negotiated Rate |
$276.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$228.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$276.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.37
|
|
|
SCREW ZIM LAG SHT 11810522
|
Facility
|
OP
|
$1,142.45
|
|
| Hospital Charge Code |
270601441
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.37 |
| Max. Negotiated Rate |
$571.23 |
| Rate for Payer: Aetna Commercial |
$342.74
|
| Rate for Payer: Aetna Medicare Advantage |
$342.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$291.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$291.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$228.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$291.32
|
| Rate for Payer: Cigna Commercial |
$571.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$276.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.37
|
|