|
SCREW CORTEX S/TAP 2.7x14mm
|
Facility
|
IP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
SCREW CORTEX S/TAP 2.7x16mm
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$54.72
|
| Rate for Payer: Aetna Medicare Advantage |
$43.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.72
|
| Rate for Payer: Cigna Commercial |
$72.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.09
|
|
|
SCREW CORTEX S/TAP 2.7x16mm
|
Facility
|
IP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
SCREW CORTEX S/TAP 2.7x18 MM
|
Facility
|
IP
|
$2,855.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$428.25 |
| Max. Negotiated Rate |
$690.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$571.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$690.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$428.25
|
|
|
SCREW CORTEX S/TAP 2.7x18 MM
|
Facility
|
OP
|
$2,855.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.08 |
| Max. Negotiated Rate |
$1,427.50 |
| Rate for Payer: Aetna Commercial |
$1,084.90
|
| Rate for Payer: Aetna Medicare Advantage |
$856.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$728.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$728.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$571.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$728.02
|
| Rate for Payer: Cigna Commercial |
$1,427.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$690.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$428.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$81.08
|
|
|
SCREW CORTEX S/TAP 2.7x18MM
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270640062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$54.72
|
| Rate for Payer: Aetna Medicare Advantage |
$43.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.72
|
| Rate for Payer: Cigna Commercial |
$72.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.09
|
|
|
SCREW CORTEX S/TAP 2.7x18MM
|
Facility
|
IP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270640062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
SCREW CORTEX S/TAP 2.7x20mm
|
Facility
|
OP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$69.90 |
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Medicare Advantage |
$41.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.65
|
| Rate for Payer: Cigna Commercial |
$69.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.97
|
|
|
SCREW CORTEX S/TAP 2.7x20mm
|
Facility
|
IP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$33.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
|
|
SCREW CORTEX S/TAP 2.7 X 22 MM
|
Facility
|
IP
|
$2,855.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$428.25 |
| Max. Negotiated Rate |
$690.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$571.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$690.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$428.25
|
|
|
SCREW CORTEX S/TAP 2.7 X 22 MM
|
Facility
|
OP
|
$2,855.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.08 |
| Max. Negotiated Rate |
$1,427.50 |
| Rate for Payer: Aetna Commercial |
$1,084.90
|
| Rate for Payer: Aetna Medicare Advantage |
$856.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$728.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$728.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$571.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$728.02
|
| Rate for Payer: Cigna Commercial |
$1,427.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$690.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$428.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$81.08
|
|
|
SCREW CORTEX S/TAP 2.7x22mm
|
Facility
|
IP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643581
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$33.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
|
|
SCREW CORTEX S/TAP 2.7x22mm
|
Facility
|
OP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643581
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$69.90 |
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Medicare Advantage |
$41.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.65
|
| Rate for Payer: Cigna Commercial |
$69.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.97
|
|
|
SCREW CORTEX S/TAP 2.7x24MM
|
Facility
|
IP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
SCREW CORTEX S/TAP 2.7x24MM
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$54.72
|
| Rate for Payer: Aetna Medicare Advantage |
$43.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.72
|
| Rate for Payer: Cigna Commercial |
$72.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.09
|
|
|
SCREW CORTEX S/TAP 2.7x26MM
|
Facility
|
OP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$69.90 |
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Medicare Advantage |
$41.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.65
|
| Rate for Payer: Cigna Commercial |
$69.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.97
|
|
|
SCREW CORTEX S/TAP 2.7x26MM
|
Facility
|
IP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$33.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
|
|
SCREW CORTEX S/TAP 2.7x28MM
|
Facility
|
OP
|
$139.80
|
|
| Hospital Charge Code |
270678291
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$69.90 |
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Medicare Advantage |
$41.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.65
|
| Rate for Payer: Cigna Commercial |
$69.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.97
|
|
|
SCREW CORTEX S/TAP 2.7x28MM
|
Facility
|
IP
|
$139.80
|
|
| Hospital Charge Code |
270678291
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$33.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
|
|
SCREW CORTEX S/TAP 2.7x30MM
|
Facility
|
OP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648929
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$69.90 |
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Medicare Advantage |
$41.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.65
|
| Rate for Payer: Cigna Commercial |
$69.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.97
|
|
|
SCREW CORTEX S/TAP 2.7x30MM
|
Facility
|
IP
|
$139.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648929
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$33.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
|
|
SCREW CORTEX S/TAP 2.7x32mm
|
Facility
|
OP
|
$135.75
|
|
| Hospital Charge Code |
270656720
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$67.88 |
| Rate for Payer: Aetna Commercial |
$51.59
|
| Rate for Payer: Aetna Medicare Advantage |
$40.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.62
|
| Rate for Payer: Cigna Commercial |
$67.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.86
|
|
|
SCREW CORTEX S/TAP 2.7x32mm
|
Facility
|
IP
|
$135.75
|
|
| Hospital Charge Code |
270656720
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$32.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.36
|
|
|
SCREW CORTEX S/TAP 2.7x32MM
|
Facility
|
OP
|
$139.80
|
|
| Hospital Charge Code |
270678293
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$69.90 |
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Medicare Advantage |
$41.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.65
|
| Rate for Payer: Cigna Commercial |
$69.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.97
|
|
|
SCREW CORTEX S/TAP 2.7x32MM
|
Facility
|
IP
|
$139.80
|
|
| Hospital Charge Code |
270678293
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$33.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.97
|
|