|
SCREW STALIF C ABO 4X13CM
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$570.00
|
| Rate for Payer: Aetna Medicare Advantage |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
SCREW STALIF C ABO 4X13CM
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
SCREW STALIF C CERV ABO 4X14MM
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
SCREW STALIF C CERV ABO 4X14MM
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$570.00
|
| Rate for Payer: Aetna Medicare Advantage |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
SCREW S/TAPPING 5.0x14MM STER
|
Facility
|
OP
|
$1,257.00
|
|
| Hospital Charge Code |
270677139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$628.50 |
| Rate for Payer: Aetna Commercial |
$477.66
|
| Rate for Payer: Aetna Medicare Advantage |
$377.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$320.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$320.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$251.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$320.54
|
| Rate for Payer: Cigna Commercial |
$628.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.70
|
|
|
SCREW S/TAPPING 5.0x14MM STER
|
Facility
|
IP
|
$1,257.00
|
|
| Hospital Charge Code |
270677139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.55 |
| Max. Negotiated Rate |
$304.19 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$251.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.55
|
|
|
SCREW S/TAPPING 5.0x16MM STER
|
Facility
|
OP
|
$1,257.00
|
|
| Hospital Charge Code |
270677140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$628.50 |
| Rate for Payer: Aetna Commercial |
$477.66
|
| Rate for Payer: Aetna Medicare Advantage |
$377.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$320.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$320.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$251.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$320.54
|
| Rate for Payer: Cigna Commercial |
$628.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.70
|
|
|
SCREW S/TAPPING 5.0x16MM STER
|
Facility
|
IP
|
$1,257.00
|
|
| Hospital Charge Code |
270677140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.55 |
| Max. Negotiated Rate |
$304.19 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$251.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.55
|
|
|
SCREW S/TAPPING 5.0x18MM STER
|
Facility
|
IP
|
$1,257.00
|
|
| Hospital Charge Code |
270677141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.55 |
| Max. Negotiated Rate |
$304.19 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$251.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.55
|
|
|
SCREW S/TAPPING 5.0x18MM STER
|
Facility
|
OP
|
$1,257.00
|
|
| Hospital Charge Code |
270677141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$628.50 |
| Rate for Payer: Aetna Commercial |
$477.66
|
| Rate for Payer: Aetna Medicare Advantage |
$377.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$320.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$320.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$251.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$320.54
|
| Rate for Payer: Cigna Commercial |
$628.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.70
|
|
|
SCREW STAR DRIVER 5.0 MM 12 MM
|
Facility
|
OP
|
$1,296.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.81 |
| Max. Negotiated Rate |
$648.08 |
| Rate for Payer: Aetna Commercial |
$492.54
|
| Rate for Payer: Aetna Medicare Advantage |
$388.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$330.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$330.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$259.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$330.52
|
| Rate for Payer: Cigna Commercial |
$648.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$313.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$40.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.81
|
|
|
SCREW STAR DRIVER 5.0 MM 12 MM
|
Facility
|
IP
|
$1,296.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.42 |
| Max. Negotiated Rate |
$313.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$259.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$313.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.42
|
|
|
SCREW STD SELF DRILL 3.5X12MM
|
Facility
|
OP
|
$6,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna Commercial |
$2,565.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,025.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,721.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,721.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,721.25
|
| Rate for Payer: Cigna Commercial |
$3,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,633.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$213.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$191.70
|
|
|
SCREW STD SELF DRILL 3.5X12MM
|
Facility
|
IP
|
$6,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,012.50 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,633.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.50
|
|
|
SCREW ST FA RESCUE 4.5X18MM
|
Facility
|
OP
|
$1,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$625.00 |
| Rate for Payer: Aetna Commercial |
$475.00
|
| Rate for Payer: Aetna Medicare Advantage |
$375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$318.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$318.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$318.75
|
| Rate for Payer: Cigna Commercial |
$625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$302.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.50
|
|
|
SCREW ST FA RESCUE 4.5X18MM
|
Facility
|
IP
|
$1,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.50 |
| Max. Negotiated Rate |
$302.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$302.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.50
|
|
|
SCREW STRM LOCKING 2.7X12MM ST
|
Facility
|
IP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$188.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
|
|
SCREW STRM LOCKING 2.7X12MM ST
|
Facility
|
OP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$390.00 |
| Rate for Payer: Aetna Commercial |
$296.40
|
| Rate for Payer: Aetna Medicare Advantage |
$234.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$198.90
|
| Rate for Payer: Cigna Commercial |
$390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.15
|
|
|
SCREW STRM LOCKING 2.7X14MM ST
|
Facility
|
IP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$188.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
|
|
SCREW STRM LOCKING 2.7X14MM ST
|
Facility
|
OP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$390.00 |
| Rate for Payer: Aetna Commercial |
$296.40
|
| Rate for Payer: Aetna Medicare Advantage |
$234.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$198.90
|
| Rate for Payer: Cigna Commercial |
$390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.15
|
|
|
SCREW STRM LOCKING 2.7X16MM ST
|
Facility
|
OP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$390.00 |
| Rate for Payer: Aetna Commercial |
$296.40
|
| Rate for Payer: Aetna Medicare Advantage |
$234.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$198.90
|
| Rate for Payer: Cigna Commercial |
$390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.15
|
|
|
SCREW STRM LOCKING 2.7X16MM ST
|
Facility
|
IP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$188.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
|
|
SCREW STRM NL 2.4 X 12MM RS ST
|
Facility
|
OP
|
$920.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.13 |
| Max. Negotiated Rate |
$460.00 |
| Rate for Payer: Aetna Commercial |
$349.60
|
| Rate for Payer: Aetna Medicare Advantage |
$276.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$234.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$234.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$184.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$234.60
|
| Rate for Payer: Cigna Commercial |
$460.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.13
|
|
|
SCREW STRM NL 2.4 X 12MM RS ST
|
Facility
|
IP
|
$920.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.00 |
| Max. Negotiated Rate |
$222.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$184.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.00
|
|
|
SCREW STRM NL LP 2.7X14MM ST
|
Facility
|
OP
|
$780.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$390.00 |
| Rate for Payer: Aetna Commercial |
$296.40
|
| Rate for Payer: Aetna Medicare Advantage |
$234.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$156.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$198.90
|
| Rate for Payer: Cigna Commercial |
$390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.15
|
|