|
SCREW CORTICAL 2.4X18MM
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693609
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$133.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
SCREW CORTICAL 2.4X18MM
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693609
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.62 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: Aetna Medicare Advantage |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$110.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$275.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.62
|
|
|
SCREW CORTICAL 2.7MM SELF TAP
|
Facility
|
IP
|
$109.55
|
|
| Hospital Charge Code |
270661359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$26.51 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.43
|
|
|
SCREW CORTICAL 2.7MM SELF TAP
|
Facility
|
OP
|
$109.55
|
|
| Hospital Charge Code |
270661359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$54.77 |
| Rate for Payer: Aetna Commercial |
$41.63
|
| Rate for Payer: Aetna Medicare Advantage |
$32.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.94
|
| Rate for Payer: Cigna Commercial |
$54.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.11
|
|
|
SCREW CORTICAL 2.7 MM X 14 MM
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7 MM X 14 MM
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x10MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270671908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x10MM
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270671908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7x12MM
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x12MM
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7x16MM
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7x16MM
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x20MM
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270671910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7x20MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270671910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x22MM
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
278643580S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
SCREW CORTICAL 2.7x22MM
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643580S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
SCREW CORTICAL 2.7x22MM
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
278643580S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.82
|
|
|
SCREW CORTICAL 2.7x22MM
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643580S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.82
|
|
|
SCREW CORTICAL 2.7x24MM
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671912
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x24MM
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671912
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7X26
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671913
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7X26
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671913
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 2.7x30MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270671915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW CORTICAL 2.7x30MM
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270671915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
SCREW CORTICAL 3.0X20MM
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.62 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: Aetna Medicare Advantage |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$110.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$275.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.62
|
|