|
SCREW CREO AMP 6.5X40MM
|
Facility
|
OP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.30 |
| Max. Negotiated Rate |
$1,625.00 |
| Rate for Payer: Aetna Commercial |
$1,235.00
|
| Rate for Payer: Aetna Medicare Advantage |
$975.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$828.75
|
| Rate for Payer: Cigna Commercial |
$1,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$102.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$92.30
|
|
|
SCREW CREO AMP 6.5X40MM
|
Facility
|
OP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693437
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.30 |
| Max. Negotiated Rate |
$1,625.00 |
| Rate for Payer: Aetna Commercial |
$1,235.00
|
| Rate for Payer: Aetna Medicare Advantage |
$975.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$828.75
|
| Rate for Payer: Cigna Commercial |
$1,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$102.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$92.30
|
|
|
SCREW CREO AMP 6.5X40MM
|
Facility
|
IP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693437
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$487.50 |
| Max. Negotiated Rate |
$786.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
|
|
SCREW CREO AMP CANMOD 6.5X40MM
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696988
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.75 |
| Max. Negotiated Rate |
$877.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
|
|
SCREW CREO AMP CANMOD 6.5X40MM
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696988
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.95 |
| Max. Negotiated Rate |
$1,812.50 |
| Rate for Payer: Aetna Commercial |
$1,377.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,087.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$924.38
|
| Rate for Payer: Cigna Commercial |
$1,812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$102.95
|
|
|
SCREW CREO AMP CANMOD 6.5X45MM
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.95 |
| Max. Negotiated Rate |
$1,812.50 |
| Rate for Payer: Aetna Commercial |
$1,377.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,087.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$924.38
|
| Rate for Payer: Cigna Commercial |
$1,812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$102.95
|
|
|
SCREW CREO AMP CANMOD 6.5X45MM
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.75 |
| Max. Negotiated Rate |
$877.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
|
|
SCREW CREO AMP MOD 7.5X40MM
|
Facility
|
OP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696767
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.30 |
| Max. Negotiated Rate |
$1,625.00 |
| Rate for Payer: Aetna Commercial |
$1,235.00
|
| Rate for Payer: Aetna Medicare Advantage |
$975.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$828.75
|
| Rate for Payer: Cigna Commercial |
$1,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$102.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$92.30
|
|
|
SCREW CREO AMP MOD 7.5X40MM
|
Facility
|
IP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696767
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$487.50 |
| Max. Negotiated Rate |
$786.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
|
|
SCREW CREO MOD CANN 5.5X40MM
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697448
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.75 |
| Max. Negotiated Rate |
$877.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
|
|
SCREW CREO MOD CANN 5.5X40MM
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697448
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.95 |
| Max. Negotiated Rate |
$1,812.50 |
| Rate for Payer: Aetna Commercial |
$1,377.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,087.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$924.38
|
| Rate for Payer: Cigna Commercial |
$1,812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$102.95
|
|
|
SCREW CREO MOD CANN 7.5X40MM
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.75 |
| Max. Negotiated Rate |
$877.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
|
|
SCREW CREO MOD CANN 7.5X40MM
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.95 |
| Max. Negotiated Rate |
$1,812.50 |
| Rate for Payer: Aetna Commercial |
$1,377.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,087.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$924.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$924.38
|
| Rate for Payer: Cigna Commercial |
$1,812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$543.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$102.95
|
|
|
SCREW CREO MOD FEN 6.5X45MM
|
Facility
|
OP
|
$4,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Aetna Commercial |
$1,520.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,020.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,020.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,020.00
|
| Rate for Payer: Cigna Commercial |
$2,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$600.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$126.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$113.60
|
|
|
SCREW CREO MOD FEN 6.5X45MM
|
Facility
|
IP
|
$4,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$600.00 |
| Max. Negotiated Rate |
$968.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$600.00
|
|
|
SCREW CREO SD 6.5X45MM
|
Facility
|
OP
|
$4,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$2,175.00 |
| Rate for Payer: Aetna Commercial |
$1,653.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,305.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,109.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,109.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$870.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,109.25
|
| Rate for Payer: Cigna Commercial |
$2,175.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,052.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$137.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$123.54
|
|
|
SCREW CREO SD 6.5X45MM
|
Facility
|
IP
|
$4,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$652.50 |
| Max. Negotiated Rate |
$1,052.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$870.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,052.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.50
|
|
|
SCREW CREO TICOCRPOLY 6.5X50MM
|
Facility
|
OP
|
$9,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.60 |
| Max. Negotiated Rate |
$4,500.00 |
| Rate for Payer: Aetna Commercial |
$3,420.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,700.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,295.00
|
| Rate for Payer: Cigna Commercial |
$4,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,178.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,350.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$284.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$255.60
|
|
|
SCREW CREO TICOCRPOLY 6.5X50MM
|
Facility
|
IP
|
$9,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$2,178.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,178.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,350.00
|
|
|
SCREW CRETX 3.5MM 28MM
|
Facility
|
IP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|
|
SCREW CRETX 3.5MM 28MM
|
Facility
|
OP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$77.58 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare Advantage |
$46.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.56
|
| Rate for Payer: Cigna Commercial |
$77.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.41
|
|
|
SCREW CRETX 3.5 MM X22 MM
|
Facility
|
IP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|
|
SCREW CRETX 3.5 MM X22 MM
|
Facility
|
OP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$77.58 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare Advantage |
$46.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.56
|
| Rate for Payer: Cigna Commercial |
$77.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.41
|
|
|
SCREW CRETX 3.5 MM X24 MM
|
Facility
|
OP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$77.58 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare Advantage |
$46.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.56
|
| Rate for Payer: Cigna Commercial |
$77.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.41
|
|
|
SCREW CRETX 3.5 MM X24 MM
|
Facility
|
IP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|