|
SCREW 3.5 X 44 NON LOCKING
|
Facility
|
IP
|
$1,365.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$330.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$273.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$330.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.75
|
|
|
SCREW 3.5X 50MM LAPIDUS
|
Facility
|
OP
|
$1,380.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686977
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$690.00 |
| Rate for Payer: Aetna Commercial |
$524.40
|
| Rate for Payer: Aetna Medicare Advantage |
$414.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$351.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$351.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$276.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$351.90
|
| Rate for Payer: Cigna Commercial |
$690.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$333.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$207.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$43.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.19
|
|
|
SCREW 3.5X 50MM LAPIDUS
|
Facility
|
IP
|
$1,380.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686977
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.00 |
| Max. Negotiated Rate |
$333.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$276.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$333.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$207.00
|
|
|
SCREW 3.7MM CANN CONICAL 36MM
|
Facility
|
IP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.03 |
| Max. Negotiated Rate |
$214.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
|
|
SCREW 3.7MM CANN CONICAL 36MM
|
Facility
|
OP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$443.45 |
| Rate for Payer: Aetna Commercial |
$337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$266.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.16
|
| Rate for Payer: Cigna Commercial |
$443.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.19
|
|
|
SCREW 3.7MM CANN CONICAL 38MM
|
Facility
|
OP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$443.45 |
| Rate for Payer: Aetna Commercial |
$337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$266.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.16
|
| Rate for Payer: Cigna Commercial |
$443.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.19
|
|
|
SCREW 3.7MM CANN CONICAL 38MM
|
Facility
|
IP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.03 |
| Max. Negotiated Rate |
$214.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
|
|
SCREW 3.7MM CANN CONICAL 40MM
|
Facility
|
IP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.03 |
| Max. Negotiated Rate |
$214.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
|
|
SCREW 3.7MM CANN CONICAL 40MM
|
Facility
|
OP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$443.45 |
| Rate for Payer: Aetna Commercial |
$337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$266.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.16
|
| Rate for Payer: Cigna Commercial |
$443.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.19
|
|
|
SCREW 3.7MM CANN CONICAL 44MM
|
Facility
|
IP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.03 |
| Max. Negotiated Rate |
$214.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
|
|
SCREW 3.7MM CANN CONICAL 44MM
|
Facility
|
OP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$443.45 |
| Rate for Payer: Aetna Commercial |
$337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$266.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.16
|
| Rate for Payer: Cigna Commercial |
$443.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.19
|
|
|
SCREW 3.7MM CANN CONICAL 75MM
|
Facility
|
OP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$443.45 |
| Rate for Payer: Aetna Commercial |
$337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$266.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.16
|
| Rate for Payer: Cigna Commercial |
$443.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.19
|
|
|
SCREW 3.7MM CANN CONICAL 75MM
|
Facility
|
IP
|
$886.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.03 |
| Max. Negotiated Rate |
$214.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.03
|
|
|
SCREW 3.7MM CANN LOCKING 30MM
|
Facility
|
IP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.42 |
| Max. Negotiated Rate |
$244.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.42
|
|
|
SCREW 3.7MM CANN LOCKING 30MM
|
Facility
|
OP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$504.73 |
| Rate for Payer: Aetna Commercial |
$383.59
|
| Rate for Payer: Aetna Medicare Advantage |
$302.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$257.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$257.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$257.41
|
| Rate for Payer: Cigna Commercial |
$504.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.67
|
|
|
SCREW 3.7MM CANN LOCKING 34MM
|
Facility
|
OP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$504.73 |
| Rate for Payer: Aetna Commercial |
$383.59
|
| Rate for Payer: Aetna Medicare Advantage |
$302.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$257.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$257.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$257.41
|
| Rate for Payer: Cigna Commercial |
$504.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.67
|
|
|
SCREW 3.7MM CANN LOCKING 34MM
|
Facility
|
IP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.42 |
| Max. Negotiated Rate |
$244.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.42
|
|
|
SCREW 3.7mm CANN LOCKING 36mm
|
Facility
|
IP
|
$812.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$196.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.90
|
|
|
SCREW 3.7mm CANN LOCKING 36mm
|
Facility
|
OP
|
$812.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$406.32 |
| Rate for Payer: Aetna Commercial |
$308.81
|
| Rate for Payer: Aetna Medicare Advantage |
$243.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.23
|
| Rate for Payer: Cigna Commercial |
$406.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.08
|
|
|
SCREW 3.7MM CANN LOCKING 46MM
|
Facility
|
OP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$504.73 |
| Rate for Payer: Aetna Commercial |
$383.59
|
| Rate for Payer: Aetna Medicare Advantage |
$302.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$257.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$257.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$257.41
|
| Rate for Payer: Cigna Commercial |
$504.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.67
|
|
|
SCREW 3.7MM CANN LOCKING 46MM
|
Facility
|
IP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.42 |
| Max. Negotiated Rate |
$244.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.42
|
|
|
SCREW 3.7mm CANN LOCKING 54mm
|
Facility
|
IP
|
$812.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$196.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.90
|
|
|
SCREW 3.7mm CANN LOCKING 54mm
|
Facility
|
OP
|
$812.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$406.32 |
| Rate for Payer: Aetna Commercial |
$308.81
|
| Rate for Payer: Aetna Medicare Advantage |
$243.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.23
|
| Rate for Payer: Cigna Commercial |
$406.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.08
|
|
|
SCREW 3.7mm CANN LOCKING 56mm
|
Facility
|
IP
|
$812.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$196.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.90
|
|
|
SCREW 3.7mm CANN LOCKING 56mm
|
Facility
|
OP
|
$812.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$406.32 |
| Rate for Payer: Aetna Commercial |
$308.81
|
| Rate for Payer: Aetna Medicare Advantage |
$243.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.23
|
| Rate for Payer: Cigna Commercial |
$406.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.08
|
|