|
SCREW CORTEX 2.0x16MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604175
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x16MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604175
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.47
|
|
|
SCREW CORTEX 2.0X16MM
|
Facility
|
IP
|
$124.50
|
|
| Hospital Charge Code |
270668166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$30.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.68
|
|
|
SCREW CORTEX 2.0X16MM
|
Facility
|
OP
|
$124.50
|
|
| Hospital Charge Code |
270668166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Aetna Commercial |
$47.31
|
| Rate for Payer: Aetna Medicare Advantage |
$37.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.75
|
| Rate for Payer: Cigna Commercial |
$62.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.54
|
|
|
SCREW CORTEX 2.0x18MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604176
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x18MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604176
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.47
|
|
|
SCREW CORTEX 2.0x20MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604177
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x20MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604177
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.47
|
|
|
SCREW CORTEX 2.0x8MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.47
|
|
|
SCREW CORTEX 2.0x8MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.4mm 12MM
|
Facility
|
OP
|
$525.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$199.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.91
|
|
|
SCREW CORTEX 2.4mm 12MM
|
Facility
|
IP
|
$525.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$127.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$105.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
SCREW CORTEX 2.4 MM SLF T8 14
|
Facility
|
OP
|
$326.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688277
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$163.32 |
| Rate for Payer: Aetna Commercial |
$124.13
|
| Rate for Payer: Aetna Medicare Advantage |
$98.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.30
|
| Rate for Payer: Cigna Commercial |
$163.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.28
|
|
|
SCREW CORTEX 2.4 MM SLF T8 14
|
Facility
|
IP
|
$326.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688277
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$79.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$65.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.00
|
|
|
SCREW CORTEX 2.4x14MM
|
Facility
|
IP
|
$326.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$79.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$65.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.00
|
|
|
SCREW CORTEX 2.4x14MM
|
Facility
|
OP
|
$326.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$163.32 |
| Rate for Payer: Aetna Commercial |
$124.13
|
| Rate for Payer: Aetna Medicare Advantage |
$98.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.30
|
| Rate for Payer: Cigna Commercial |
$163.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.28
|
|
|
SCREW CORTEX 2.4X 14 MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
270703506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$284.20 |
| Rate for Payer: Aetna Commercial |
$215.99
|
| Rate for Payer: Aetna Medicare Advantage |
$170.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.94
|
| Rate for Payer: Cigna Commercial |
$284.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.14
|
|
|
SCREW CORTEX 2.4X 14 MM
|
Facility
|
IP
|
$568.40
|
|
| Hospital Charge Code |
270703506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$137.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.4 X 16 MM
|
Facility
|
OP
|
$568.40
|
|
| Hospital Charge Code |
270703507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$284.20 |
| Rate for Payer: Aetna Commercial |
$215.99
|
| Rate for Payer: Aetna Medicare Advantage |
$170.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.94
|
| Rate for Payer: Cigna Commercial |
$284.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.14
|
|
|
SCREW CORTEX 2.4 X 16 MM
|
Facility
|
IP
|
$568.40
|
|
| Hospital Charge Code |
270703507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$137.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.26
|
|
|
SCREW CORTEX 2.4 X 16MM
|
Facility
|
OP
|
$210.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$105.03 |
| Rate for Payer: Aetna Commercial |
$79.82
|
| Rate for Payer: Aetna Medicare Advantage |
$63.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.56
|
| Rate for Payer: Cigna Commercial |
$105.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.97
|
|
|
SCREW CORTEX 2.4 X 16MM
|
Facility
|
IP
|
$210.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.51 |
| Max. Negotiated Rate |
$50.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.51
|
|
|
SCREW CORTEX 2.4X18MM
|
Facility
|
OP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.83 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: Aetna Commercial |
$372.40
|
| Rate for Payer: Aetna Medicare Advantage |
$294.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$249.90
|
| Rate for Payer: Cigna Commercial |
$490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.83
|
|
|
SCREW CORTEX 2.4X18MM
|
Facility
|
IP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$237.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
SCREW CORTEX 2.7x14MM
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.24
|
|