|
SCREW CORTEX SELFTAP 1.3x14mm
|
Facility
|
OP
|
$318.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Aetna Medicare Advantage |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.09
|
| Rate for Payer: Cigna Commercial |
$159.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.03
|
|
|
SCREW CORTEX SELFTAP 1.3x14mm
|
Facility
|
IP
|
$318.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$76.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
|
|
SCREW CORTEX SELFTAP 1.3x16mm
|
Facility
|
OP
|
$318.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Aetna Medicare Advantage |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.09
|
| Rate for Payer: Cigna Commercial |
$159.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.03
|
|
|
SCREW CORTEX SELFTAP 1.3x16mm
|
Facility
|
IP
|
$318.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$76.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
|
|
SCREW CORTEX SELFTAP 1.3x6mm
|
Facility
|
IP
|
$318.00
|
|
| Hospital Charge Code |
270656245
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$76.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
|
|
SCREW CORTEX SELFTAP 1.3x6mm
|
Facility
|
OP
|
$318.00
|
|
| Hospital Charge Code |
270656245
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Aetna Medicare Advantage |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.09
|
| Rate for Payer: Cigna Commercial |
$159.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.03
|
|
|
SCREW CORTEX SELFTAP 1.3x7mm
|
Facility
|
IP
|
$318.00
|
|
| Hospital Charge Code |
270656246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$76.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
|
|
SCREW CORTEX SELFTAP 1.3x7mm
|
Facility
|
OP
|
$318.00
|
|
| Hospital Charge Code |
270656246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Aetna Medicare Advantage |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.09
|
| Rate for Payer: Cigna Commercial |
$159.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.03
|
|
|
SCREW CORTEX SELFTAP 1.3x8mm
|
Facility
|
OP
|
$318.00
|
|
| Hospital Charge Code |
270656247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Aetna Medicare Advantage |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.09
|
| Rate for Payer: Cigna Commercial |
$159.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.03
|
|
|
SCREW CORTEX SELFTAP 1.3x8mm
|
Facility
|
IP
|
$318.00
|
|
| Hospital Charge Code |
270656247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$76.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
|
|
SCREW CORTEX SELFTAP 1.3x9mm
|
Facility
|
IP
|
$318.00
|
|
| Hospital Charge Code |
270656249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.70 |
| Max. Negotiated Rate |
$76.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
|
|
SCREW CORTEX SELFTAP 1.3x9mm
|
Facility
|
OP
|
$318.00
|
|
| Hospital Charge Code |
270656249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Aetna Medicare Advantage |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.09
|
| Rate for Payer: Cigna Commercial |
$159.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.03
|
|
|
SCREW CORTEX SELFTAP 1.5x10mm
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.05
|
|
|
SCREW CORTEX SELFTAP 1.5x10mm
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$34.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELFTAP 1.5x11mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x11mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.93
|
|
|
SCREW CORTEX SELFTAP 1.5x12mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.93
|
|
|
SCREW CORTEX SELFTAP 1.5x12mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x13mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.93
|
|
|
SCREW CORTEX SELFTAP 1.5x13mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x14mm
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.05
|
|
|
SCREW CORTEX SELFTAP 1.5x14mm
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$34.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELFTAP 1.5x14MM
|
Facility
|
OP
|
$148.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$74.15 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare Advantage |
$44.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.82
|
| Rate for Payer: Cigna Commercial |
$74.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.21
|
|
|
SCREW CORTEX SELFTAP 1.5x14MM
|
Facility
|
IP
|
$148.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.25 |
| Max. Negotiated Rate |
$35.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
|
|
SCREW CORTEX SELFTAP 1.5x16mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|