|
SCREW COMPR HDLSS LNG 2.4x24MM
|
Facility
|
OP
|
$6,705.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$190.45 |
| Max. Negotiated Rate |
$3,352.97 |
| Rate for Payer: Aetna Commercial |
$2,548.26
|
| Rate for Payer: Aetna Medicare Advantage |
$2,011.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,710.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,710.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,341.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,710.02
|
| Rate for Payer: Cigna Commercial |
$3,352.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,622.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$211.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$190.45
|
|
|
SCREW COMPR HDLSS LNG 2.4x24MM
|
Facility
|
IP
|
$6,705.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.89 |
| Max. Negotiated Rate |
$1,622.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,341.19
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,622.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.89
|
|
|
SCREW COMPR HEADLESS 2.4x16MM
|
Facility
|
OP
|
$147.30
|
|
| Hospital Charge Code |
270678208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$73.65 |
| Rate for Payer: Aetna Commercial |
$55.97
|
| Rate for Payer: Aetna Medicare Advantage |
$44.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.56
|
| Rate for Payer: Cigna Commercial |
$73.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.18
|
|
|
SCREW COMPR HEADLESS 2.4x16MM
|
Facility
|
IP
|
$147.30
|
|
| Hospital Charge Code |
270678208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.09 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.09
|
|
|
SCREW COMPR HEADLESS 2.4x22MM
|
Facility
|
IP
|
$147.30
|
|
| Hospital Charge Code |
270678209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.09 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.09
|
|
|
SCREW COMPR HEADLESS 2.4x22MM
|
Facility
|
OP
|
$147.30
|
|
| Hospital Charge Code |
270678209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$73.65 |
| Rate for Payer: Aetna Commercial |
$55.97
|
| Rate for Payer: Aetna Medicare Advantage |
$44.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.56
|
| Rate for Payer: Cigna Commercial |
$73.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.18
|
|
|
SCREW COMPR HEADLESS 2.4x40MM
|
Facility
|
OP
|
$1,452.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$726.15 |
| Rate for Payer: Aetna Commercial |
$551.87
|
| Rate for Payer: Aetna Medicare Advantage |
$435.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$370.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$370.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$290.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$370.34
|
| Rate for Payer: Cigna Commercial |
$726.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$351.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.84
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.25
|
|
|
SCREW COMPR HEADLESS 2.4x40MM
|
Facility
|
IP
|
$1,452.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$217.84 |
| Max. Negotiated Rate |
$351.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$290.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$351.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.84
|
|
|
SCREW COMPR LKG 3.0X16MM
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$822.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$822.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$510.00
|
|
|
SCREW COMPR LKG 3.0X16MM
|
Facility
|
OP
|
$3,400.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.56 |
| Max. Negotiated Rate |
$1,700.00 |
| Rate for Payer: Aetna Commercial |
$1,292.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,020.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$867.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$867.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$680.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$867.00
|
| Rate for Payer: Cigna Commercial |
$1,700.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$822.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$510.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.56
|
|
|
SCREW COMPR LKG 3.0X18MM
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$822.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$822.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$510.00
|
|
|
SCREW COMPR LKG 3.0X18MM
|
Facility
|
OP
|
$3,400.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.56 |
| Max. Negotiated Rate |
$1,700.00 |
| Rate for Payer: Aetna Commercial |
$1,292.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,020.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$867.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$867.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$680.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$867.00
|
| Rate for Payer: Cigna Commercial |
$1,700.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$822.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$510.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.56
|
|
|
SCREW COMPR MICRO 2.5x30MM
|
Facility
|
IP
|
$1,475.00
|
|
| Hospital Charge Code |
270677993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW COMPR MICRO 2.5x30MM
|
Facility
|
OP
|
$1,475.00
|
|
| Hospital Charge Code |
270677993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.89
|
|
|
SCREW COMPR MINI 3.5x18MM
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW COMPR MINI 3.5x18MM
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.89
|
|
|
SCREW COMPR MINI 3.5x24MM
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW COMPR MINI 3.5x24MM
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.89
|
|
|
SCREW COMPR SHRT 3.0x32mm
|
Facility
|
OP
|
$1,495.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.48 |
| Max. Negotiated Rate |
$747.92 |
| Rate for Payer: Aetna Commercial |
$568.42
|
| Rate for Payer: Aetna Medicare Advantage |
$448.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$299.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$381.44
|
| Rate for Payer: Cigna Commercial |
$747.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$224.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.48
|
|
|
SCREW COMPR SHRT 3.0x32mm
|
Facility
|
IP
|
$1,495.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.38 |
| Max. Negotiated Rate |
$362.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$299.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$224.38
|
|
|
SCREW COMPR SHRT 3.0x32mm
|
Facility
|
IP
|
$1,495.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681869
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.38 |
| Max. Negotiated Rate |
$362.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$299.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$224.38
|
|
|
SCREW COMPR SHRT 3.0x32mm
|
Facility
|
OP
|
$1,495.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681869
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.48 |
| Max. Negotiated Rate |
$747.92 |
| Rate for Payer: Aetna Commercial |
$568.42
|
| Rate for Payer: Aetna Medicare Advantage |
$448.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$299.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$381.44
|
| Rate for Payer: Cigna Commercial |
$747.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$224.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.48
|
|
|
SCREW COMPR SHRT 3.0x40mm
|
Facility
|
IP
|
$1,495.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681870
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.38 |
| Max. Negotiated Rate |
$362.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$299.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$224.38
|
|
|
SCREW COMPR SHRT 3.0x40mm
|
Facility
|
OP
|
$1,495.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681870
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.48 |
| Max. Negotiated Rate |
$747.92 |
| Rate for Payer: Aetna Commercial |
$568.42
|
| Rate for Payer: Aetna Medicare Advantage |
$448.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$381.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$299.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$381.44
|
| Rate for Payer: Cigna Commercial |
$747.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$224.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.48
|
|
|
SCREW COMP RVS CNTRL 6.5X20MM
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|