|
SCREW 6.5MM CANC FULL
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
IP
|
$135.00
|
|
| Hospital Charge Code |
270656204
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
IP
|
$135.00
|
|
| Hospital Charge Code |
270656201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656204
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
IP
|
$135.00
|
|
| Hospital Charge Code |
270656199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
IP
|
$135.00
|
|
| Hospital Charge Code |
270656197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL THREAD
|
Facility
|
OP
|
$135.00
|
|
| Hospital Charge Code |
270656196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.83
|
|
|
SCREW 6.5MM CANC FULL THREAD
|
Facility
|
IP
|
$135.00
|
|
| Hospital Charge Code |
270656196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW 6.5MM LOW PROF HEX 35MM
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.00 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$1,900.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,275.00
|
| Rate for Payer: Cigna Commercial |
$2,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$158.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$142.00
|
|
|
SCREW 6.5MM LOW PROF HEX 35MM
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$1,210.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
|
|
SCREW 6.5MM X40MM OW EXT TAB
|
Facility
|
IP
|
$5,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692585
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.50 |
| Max. Negotiated Rate |
$1,270.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,050.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,270.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$787.50
|
|
|
SCREW 6.5MM X40MM OW EXT TAB
|
Facility
|
OP
|
$5,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692585
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna Commercial |
$1,995.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,575.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,338.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,338.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,338.75
|
| Rate for Payer: Cigna Commercial |
$2,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,270.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$787.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$165.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$149.10
|
|
|
SCREW 6.5MM X45MM OW EXT TAB
|
Facility
|
IP
|
$5,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692586
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.50 |
| Max. Negotiated Rate |
$1,270.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,050.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,270.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$787.50
|
|
|
SCREW 6.5MM X45MM OW EXT TAB
|
Facility
|
OP
|
$5,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692586
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna Commercial |
$1,995.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,575.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,338.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,338.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,338.75
|
| Rate for Payer: Cigna Commercial |
$2,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,270.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$787.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$165.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$149.10
|
|
|
SCREW 6.5X30MM
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$484.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$484.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
|
SCREW 6.5X30MM
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.80 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$760.00
|
| Rate for Payer: Aetna Medicare Advantage |
$600.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$510.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$510.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$400.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$510.00
|
| Rate for Payer: Cigna Commercial |
$1,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$484.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$56.80
|
|
|
SCREW 6.5X30MM
|
Facility
|
IP
|
$2,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$532.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$440.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$532.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$330.00
|
|
|
SCREW 6.5X30MM
|
Facility
|
OP
|
$2,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$62.48 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$836.00
|
| Rate for Payer: Aetna Medicare Advantage |
$660.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$561.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$561.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$440.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$561.00
|
| Rate for Payer: Cigna Commercial |
$1,100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$532.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$330.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$69.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$62.48
|
|
|
SCREW 6.5X35MM
|
Facility
|
OP
|
$5,450.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.78 |
| Max. Negotiated Rate |
$2,725.00 |
| Rate for Payer: Aetna Commercial |
$2,071.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,635.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,389.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,389.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,090.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,389.75
|
| Rate for Payer: Cigna Commercial |
$2,725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,318.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$817.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$172.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$154.78
|
|
|
SCREW 6.5X35MM
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$156.20 |
| Max. Negotiated Rate |
$2,750.00 |
| Rate for Payer: Aetna Commercial |
$2,090.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,402.50
|
| Rate for Payer: Cigna Commercial |
$2,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,331.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$173.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$156.20
|
|
|
SCREW 6.5X35MM
|
Facility
|
OP
|
$4,500.00
|
|
| Hospital Charge Code |
270703134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,710.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,147.50
|
| Rate for Payer: Cigna Commercial |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$142.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$127.80
|
|