|
SCREW NON LOCKING 3.5x34MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270672117
|
|
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 NON LOCKING 3.5x36MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667745
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.35
|
|
|
SCREW NON LOCKING 3.5x36MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667745
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x38mm
|
Facility
|
IP
|
$340.00
|
|
| Hospital Charge Code |
270673028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW NON LOCKING 3.5x38mm
|
Facility
|
OP
|
$340.00
|
|
| Hospital Charge Code |
270673028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.66 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.66
|
|
|
SCREW NON LOCKING 3.5x38MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x38MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270672118
|
|
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 NON LOCKING 3.5x38MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.35
|
|
|
SCREW NON LOCKING 3.5x38MM
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270672118
|
|
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 NON LOCKING 3.5x40MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x40MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.35
|
|
|
SCREW NON LOCKING 3.5X 40 MM
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$159.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
SCREW NON LOCKING 3.5X 40 MM
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$250.80
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.74
|
|
|
SCREW NON LOCKING 3.5x44mm
|
Facility
|
OP
|
$340.00
|
|
| Hospital Charge Code |
270673027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.66 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.66
|
|
|
SCREW NON LOCKING 3.5x44mm
|
Facility
|
IP
|
$340.00
|
|
| Hospital Charge Code |
270673027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW NON LOCKING 3.5x44MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.35
|
|
|
SCREW NON LOCKING 3.5x44MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5X46
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701210
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$159.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
SCREW NON LOCKING 3.5X46
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701210
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$250.80
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.74
|
|
|
SCREW NON LOCKING 3.5x46MM
|
Facility
|
IP
|
$470.00
|
|
| Hospital Charge Code |
270667701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x46MM
|
Facility
|
OP
|
$470.00
|
|
| Hospital Charge Code |
270667701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.35
|
|
|
SCREW NON LOCKING 4.0x2.6mm
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.74 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Aetna Commercial |
$264.10
|
| Rate for Payer: Aetna Medicare Advantage |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$139.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$177.22
|
| Rate for Payer: Cigna Commercial |
$347.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$168.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.74
|
|
|
SCREW NON LOCKING 4.0x2.6mm
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.25 |
| Max. Negotiated Rate |
$168.19 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$139.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$168.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
|
|
SCREW NON-LOCKING 4.5X15MM
|
Facility
|
OP
|
$533.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$266.68 |
| Rate for Payer: Aetna Commercial |
$202.67
|
| Rate for Payer: Aetna Medicare Advantage |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$136.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$136.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$136.00
|
| Rate for Payer: Cigna Commercial |
$266.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.15
|
|
|
SCREW NON-LOCKING 4.5X15MM
|
Facility
|
IP
|
$533.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$129.07 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.00
|
|