|
SCREW CANN 32MM THRD 7.3x70MM
|
Facility
|
IP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.54 |
| Max. Negotiated Rate |
$265.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
|
|
SCREW CANN 32MM THRD 7.3x70MM
|
Facility
|
OP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$548.48 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare Advantage |
$329.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.72
|
| Rate for Payer: Cigna Commercial |
$548.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.15
|
|
|
SCREW CANN 32MM THRD 7.3x75MM
|
Facility
|
OP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$548.48 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare Advantage |
$329.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.72
|
| Rate for Payer: Cigna Commercial |
$548.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.15
|
|
|
SCREW CANN 32MM THRD 7.3x75MM
|
Facility
|
IP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.54 |
| Max. Negotiated Rate |
$265.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
|
|
SCREW CANN 32MM THRD 7.3x80MM
|
Facility
|
OP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605054
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$548.48 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare Advantage |
$329.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.72
|
| Rate for Payer: Cigna Commercial |
$548.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.15
|
|
|
SCREW CANN 32MM THRD 7.3x80MM
|
Facility
|
IP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605054
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.54 |
| Max. Negotiated Rate |
$265.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
|
|
SCREW CANN 32MM THRD 7.3x85MM
|
Facility
|
OP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$548.48 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare Advantage |
$329.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.72
|
| Rate for Payer: Cigna Commercial |
$548.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.15
|
|
|
SCREW CANN 32MM THRD 7.3x85MM
|
Facility
|
IP
|
$1,096.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.54 |
| Max. Negotiated Rate |
$265.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.54
|
|
|
SCREW CANN 32MM THRD 7.3x90MM
|
Facility
|
IP
|
$1,129.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605056
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.48 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.48
|
|
|
SCREW CANN 32MM THRD 7.3x90MM
|
Facility
|
OP
|
$1,129.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605056
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32.09 |
| Max. Negotiated Rate |
$564.92 |
| Rate for Payer: Aetna Commercial |
$429.34
|
| Rate for Payer: Aetna Medicare Advantage |
$338.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$288.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$288.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$288.11
|
| Rate for Payer: Cigna Commercial |
$564.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.09
|
|
|
SCREW CANN 32MM THRD 7.3x95MM
|
Facility
|
OP
|
$1,129.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32.09 |
| Max. Negotiated Rate |
$564.92 |
| Rate for Payer: Aetna Commercial |
$429.34
|
| Rate for Payer: Aetna Medicare Advantage |
$338.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$288.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$288.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$288.11
|
| Rate for Payer: Cigna Commercial |
$564.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.09
|
|
|
SCREW CANN 32MM THRD 7.3x95MM
|
Facility
|
IP
|
$1,129.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.48 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.48
|
|
|
SCREW CANN 3.5x40MM
|
Facility
|
OP
|
$1,071.00
|
|
| Hospital Charge Code |
270676288
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna Commercial |
$406.98
|
| Rate for Payer: Aetna Medicare Advantage |
$321.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$273.11
|
| Rate for Payer: Cigna Commercial |
$535.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.42
|
|
|
SCREW CANN 3.5x40MM
|
Facility
|
IP
|
$1,071.00
|
|
| Hospital Charge Code |
270676288
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.65 |
| Max. Negotiated Rate |
$259.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
|
|
SCREW CANN 3.7MM LOCKING 44MM
|
Facility
|
IP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696109
|
|
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 CANN 3.7MM LOCKING 44MM
|
Facility
|
OP
|
$1,009.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696109
|
|
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 CANN 4.0 L4.0 FULL THD
|
Facility
|
IP
|
$790.00
|
|
| Hospital Charge Code |
270669445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$118.50 |
| Max. Negotiated Rate |
$191.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$158.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$191.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.50
|
|
|
SCREW CANN 4.0 L4.0 FULL THD
|
Facility
|
OP
|
$790.00
|
|
| Hospital Charge Code |
270669445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$395.00 |
| Rate for Payer: Aetna Commercial |
$300.20
|
| Rate for Payer: Aetna Medicare Advantage |
$237.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$201.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$201.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$158.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$201.45
|
| Rate for Payer: Cigna Commercial |
$395.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$191.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.44
|
|
|
SCREW CANN 40MM THD 6.5x75MM
|
Facility
|
OP
|
$2,120.00
|
|
| Hospital Charge Code |
270674055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.21 |
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$805.60
|
| Rate for Payer: Aetna Medicare Advantage |
$636.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$424.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$540.60
|
| Rate for Payer: Cigna Commercial |
$1,060.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$513.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$318.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$66.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.21
|
|
|
SCREW CANN 40MM THD 6.5x75MM
|
Facility
|
IP
|
$2,120.00
|
|
| Hospital Charge Code |
270674055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.00 |
| Max. Negotiated Rate |
$513.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$424.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$513.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$318.00
|
|
|
SCREW CANN 4.0x20mm LONG THRD
|
Facility
|
OP
|
$810.00
|
|
| Hospital Charge Code |
270657122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$307.80
|
| Rate for Payer: Aetna Medicare Advantage |
$243.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$206.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$206.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$206.55
|
| Rate for Payer: Cigna Commercial |
$405.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.00
|
|
|
SCREW CANN 4.0x20mm LONG THRD
|
Facility
|
IP
|
$810.00
|
|
| Hospital Charge Code |
270657122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.50 |
| Max. Negotiated Rate |
$196.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.50
|
|
|
SCREW CANN 4.0X35MM ORTLOC SYS
|
Facility
|
OP
|
$468.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$177.84
|
| Rate for Payer: Aetna Medicare Advantage |
$140.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.34
|
| Rate for Payer: Cigna Commercial |
$234.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.29
|
|
|
SCREW CANN 4.0X35MM ORTLOC SYS
|
Facility
|
IP
|
$468.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.20 |
| Max. Negotiated Rate |
$113.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.20
|
|
|
SCREW CANN 4.0X40MMHEADLSSCOMP
|
Facility
|
OP
|
$2,132.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.55 |
| Max. Negotiated Rate |
$1,066.00 |
| Rate for Payer: Aetna Commercial |
$810.16
|
| Rate for Payer: Aetna Medicare Advantage |
$639.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$543.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$543.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$426.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$543.66
|
| Rate for Payer: Cigna Commercial |
$1,066.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$515.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.55
|
|