|
SCREW ZIM LAG SHT 65 11810525
|
Facility
|
IP
|
$1,142.45
|
|
| Hospital Charge Code |
270601442
|
|
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 65 11810525
|
Facility
|
OP
|
$1,142.45
|
|
| Hospital Charge Code |
270601442
|
|
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
|
|
|
SCREW ZIM LAG SHT 80 11810532
|
Facility
|
OP
|
$951.25
|
|
| Hospital Charge Code |
270616360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$475.62 |
| Rate for Payer: Aetna Commercial |
$285.38
|
| Rate for Payer: Aetna Medicare Advantage |
$285.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$242.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$242.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$190.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$242.57
|
| Rate for Payer: Cigna Commercial |
$475.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$230.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.69
|
|
|
SCREW ZIM LAG SHT 80 11810532
|
Facility
|
IP
|
$951.25
|
|
| Hospital Charge Code |
270616360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$230.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$190.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$230.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.69
|
|
|
SCREW ZIM LAG SHT 85 11810535
|
Facility
|
OP
|
$951.25
|
|
| Hospital Charge Code |
270617525
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$475.62 |
| Rate for Payer: Aetna Commercial |
$285.38
|
| Rate for Payer: Aetna Medicare Advantage |
$285.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$242.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$242.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$190.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$242.57
|
| Rate for Payer: Cigna Commercial |
$475.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$230.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.69
|
|
|
SCREW ZIM LAG SHT 85 11810535
|
Facility
|
IP
|
$951.25
|
|
| Hospital Charge Code |
270617525
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$230.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$190.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$230.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.69
|
|
|
SCREW ZIM MAGNA 4 50 1142-4150
|
Facility
|
IP
|
$548.00
|
|
| Hospital Charge Code |
270613429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.20 |
| Max. Negotiated Rate |
$132.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.20
|
|
|
SCREW ZIM MAGNA 4 50 1142-4150
|
Facility
|
OP
|
$548.00
|
|
| Hospital Charge Code |
270613429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.20 |
| Max. Negotiated Rate |
$274.00 |
| Rate for Payer: Aetna Commercial |
$164.40
|
| Rate for Payer: Aetna Medicare Advantage |
$164.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$139.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$139.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$139.74
|
| Rate for Payer: Cigna Commercial |
$274.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.20
|
|
|
SCREW ZIM MAGNA 7 32 114210032
|
Facility
|
OP
|
$756.00
|
|
| Hospital Charge Code |
270617848
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: Aetna Medicare Advantage |
$226.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$192.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$192.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$151.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$192.78
|
| Rate for Payer: Cigna Commercial |
$378.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$182.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$113.40
|
|
|
SCREW ZIM MAGNA 7 32 114210032
|
Facility
|
IP
|
$756.00
|
|
| Hospital Charge Code |
270617848
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$182.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$151.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$182.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$113.40
|
|
|
SCREW ZIM MALL 4.5 45 2334-046
|
Facility
|
IP
|
$85.65
|
|
| Hospital Charge Code |
270610355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$20.73 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.85
|
|
|
SCREW ZIM MALL 4.5 45 2334-046
|
Facility
|
OP
|
$85.65
|
|
| Hospital Charge Code |
270610355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$42.83 |
| Rate for Payer: Aetna Commercial |
$25.70
|
| Rate for Payer: Aetna Medicare Advantage |
$25.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.84
|
| Rate for Payer: Cigna Commercial |
$42.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.85
|
|
|
SCREW ZIM MGNA CANN 16 7 95
|
Facility
|
IP
|
$751.95
|
|
| Hospital Charge Code |
270606472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.79 |
| Max. Negotiated Rate |
$181.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.79
|
|
|
SCREW ZIM MGNA CANN 16 7 95
|
Facility
|
OP
|
$751.95
|
|
| Hospital Charge Code |
270606472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.79 |
| Max. Negotiated Rate |
$375.98 |
| Rate for Payer: Aetna Commercial |
$225.59
|
| Rate for Payer: Aetna Medicare Advantage |
$225.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.75
|
| Rate for Payer: Cigna Commercial |
$375.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.79
|
|
|
SCREW ZIM MGNA FIX
|
Facility
|
IP
|
$892.85
|
|
| Hospital Charge Code |
270610407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.93 |
| Max. Negotiated Rate |
$216.07 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$178.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$216.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.93
|
|
|
SCREW ZIM MGNA FIX
|
Facility
|
OP
|
$892.85
|
|
| Hospital Charge Code |
270610407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.93 |
| Max. Negotiated Rate |
$446.43 |
| Rate for Payer: Aetna Commercial |
$267.86
|
| Rate for Payer: Aetna Medicare Advantage |
$267.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$227.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$227.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$178.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$227.68
|
| Rate for Payer: Cigna Commercial |
$446.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$216.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.93
|
|
|
SCREW ZIM MGNA FIX
|
Facility
|
IP
|
$464.28
|
|
| Hospital Charge Code |
207610407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.64 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$92.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.64
|
|
|
SCREW ZIM MGNA FIX
|
Facility
|
OP
|
$464.28
|
|
| Hospital Charge Code |
207610407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.64 |
| Max. Negotiated Rate |
$232.14 |
| Rate for Payer: Aetna Commercial |
$139.28
|
| Rate for Payer: Aetna Medicare Advantage |
$139.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$118.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$118.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$92.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$118.39
|
| Rate for Payer: Cigna Commercial |
$232.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.64
|
|
|
SCREW ZIM PRTC 3.5 20 23472020
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270620802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SCREW ZIM PRTC 3.5 20 23472020
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270620802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SCREW ZIM PRTC 3.5 22 23472022
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270620803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SCREW ZIM PRTC 3.5 22 23472022
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270620803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SCREW ZIM PRTC 3.5 28 23472028
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270620804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SCREW ZIM PRTC 3.5 28 23472028
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270620804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SCREW ZIM PRTC 3.5 32 23472032
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270620805
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|