|
DRILL FIXED 12MM
|
Facility
|
OP
|
$1,041.25
|
|
| Hospital Charge Code |
270663785
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.09 |
| Max. Negotiated Rate |
$520.62 |
| Rate for Payer: Aetna Commercial |
$395.68
|
| Rate for Payer: Aetna Medicare Advantage |
$312.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$265.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$265.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$265.52
|
| Rate for Payer: Cigna Commercial |
$520.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$312.38
|
| Rate for Payer: Oxford Commercial |
$208.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$208.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.59
|
|
|
DRILL FIXED 12MM
|
Facility
|
IP
|
$1,041.25
|
|
| Hospital Charge Code |
270663785
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.19 |
| Max. Negotiated Rate |
$156.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.19
|
|
|
DRILL FLEX 1.6MM w/SHARP OBTUR
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
270683556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
DRILL FLEX 1.6MM w/SHARP OBTUR
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
270683556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$199.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.50
|
| Rate for Payer: Oxford Commercial |
$105.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$105.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.91
|
|
|
DRILL FLUTED 10MM
|
Facility
|
IP
|
$1,360.00
|
|
| Hospital Charge Code |
270637721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.00
|
|
|
DRILL FLUTED 10MM
|
Facility
|
OP
|
$1,360.00
|
|
| Hospital Charge Code |
270637721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna Commercial |
$516.80
|
| Rate for Payer: Aetna Medicare Advantage |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$346.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$346.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$346.80
|
| Rate for Payer: Cigna Commercial |
$680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$408.00
|
| Rate for Payer: Oxford Commercial |
$272.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$272.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.04
|
|
|
DRILL FOR 2.9MM PUSHLOCK
|
Facility
|
IP
|
$475.00
|
|
| Hospital Charge Code |
270656511
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
|
|
DRILL FOR 2.9MM PUSHLOCK
|
Facility
|
OP
|
$475.00
|
|
| Hospital Charge Code |
270656511
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.45 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Aetna Commercial |
$180.50
|
| Rate for Payer: Aetna Medicare Advantage |
$142.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121.12
|
| Rate for Payer: Cigna Commercial |
$237.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.50
|
| Rate for Payer: Oxford Commercial |
$95.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.59
|
|
|
DRILL FOR CALCANEM SCREW 4.3MM
|
Facility
|
IP
|
$924.00
|
|
| Hospital Charge Code |
270666232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.60
|
|
|
DRILL FOR CALCANEM SCREW 4.3MM
|
Facility
|
OP
|
$924.00
|
|
| Hospital Charge Code |
270666232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.27 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$351.12
|
| Rate for Payer: Aetna Medicare Advantage |
$277.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$235.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$235.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$235.62
|
| Rate for Payer: Cigna Commercial |
$462.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$277.20
|
| Rate for Payer: Oxford Commercial |
$184.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$184.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.49
|
|
|
DRILL GRADUATED 4.3 MM
|
Facility
|
IP
|
$984.00
|
|
| Hospital Charge Code |
270682504
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$147.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.60
|
|
|
DRILL GRADUATED 4.3 MM
|
Facility
|
OP
|
$984.00
|
|
| Hospital Charge Code |
270682504
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.71 |
| Max. Negotiated Rate |
$492.00 |
| Rate for Payer: Aetna Commercial |
$373.92
|
| Rate for Payer: Aetna Medicare Advantage |
$295.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$250.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$250.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$250.92
|
| Rate for Payer: Cigna Commercial |
$492.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.20
|
| Rate for Payer: Oxford Commercial |
$196.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$196.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.08
|
|
|
DRILL GUIDE
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270681072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.15 |
| 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) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Oxford Commercial |
$300.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$300.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
DRILL GUIDE
|
Facility
|
IP
|
$2,142.00
|
|
| Hospital Charge Code |
270671713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.30 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.30
|
|
|
DRILL GUIDE
|
Facility
|
IP
|
$2,404.05
|
|
| Hospital Charge Code |
270688226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$360.61 |
| Max. Negotiated Rate |
$360.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$360.61
|
|
|
DRILL GUIDE
|
Facility
|
OP
|
$2,404.05
|
|
| Hospital Charge Code |
270688226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$1,202.03 |
| Rate for Payer: Aetna Commercial |
$913.54
|
| Rate for Payer: Aetna Medicare Advantage |
$721.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$613.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$613.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$613.03
|
| Rate for Payer: Cigna Commercial |
$1,202.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$721.22
|
| Rate for Payer: Oxford Commercial |
$480.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$360.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$480.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$63.71
|
|
|
DRILL GUIDE
|
Facility
|
OP
|
$2,142.00
|
|
| Hospital Charge Code |
270671713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.62 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$813.96
|
| Rate for Payer: Aetna Medicare Advantage |
$642.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$546.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$546.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$546.21
|
| Rate for Payer: Cigna Commercial |
$1,071.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$642.60
|
| Rate for Payer: Oxford Commercial |
$428.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$428.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$56.76
|
|
|
DRILL GUIDE
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270681072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
DRILL GUIDE 1.8MM THREADED
|
Facility
|
OP
|
$500.55
|
|
| Hospital Charge Code |
270688231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.06 |
| Max. Negotiated Rate |
$250.28 |
| Rate for Payer: Aetna Commercial |
$190.21
|
| Rate for Payer: Aetna Medicare Advantage |
$150.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.64
|
| Rate for Payer: Cigna Commercial |
$250.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$150.16
|
| Rate for Payer: Oxford Commercial |
$100.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$100.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.26
|
|
|
DRILL GUIDE 1.8MM THREADED
|
Facility
|
IP
|
$500.55
|
|
| Hospital Charge Code |
270688231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.08 |
| Max. Negotiated Rate |
$75.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.08
|
|
|
DRILL GUIDE 1.8mm W/MEASURING
|
Facility
|
OP
|
$1,887.00
|
|
| Hospital Charge Code |
270645646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.48 |
| Max. Negotiated Rate |
$943.50 |
| Rate for Payer: Aetna Commercial |
$717.06
|
| Rate for Payer: Aetna Medicare Advantage |
$566.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$481.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$481.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$481.19
|
| Rate for Payer: Cigna Commercial |
$943.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$566.10
|
| Rate for Payer: Oxford Commercial |
$377.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$283.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$377.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50.01
|
|
|
DRILL GUIDE 1.8mm W/MEASURING
|
Facility
|
IP
|
$1,887.00
|
|
| Hospital Charge Code |
270645646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$283.05 |
| Max. Negotiated Rate |
$283.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$283.05
|
|
|
DRILL GUIDE 2.0 UNIV VA LCKG
|
Facility
|
OP
|
$2,666.65
|
|
| Hospital Charge Code |
270677659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$1,333.33 |
| Rate for Payer: Aetna Commercial |
$1,013.33
|
| Rate for Payer: Aetna Medicare Advantage |
$800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$680.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$680.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$680.00
|
| Rate for Payer: Cigna Commercial |
$1,333.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$800.00
|
| Rate for Payer: Oxford Commercial |
$533.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$400.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$533.33
|
| Rate for Payer: UnitedHealthcare Community & State |
$64.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$70.67
|
|
|
DRILL GUIDE 2.0 UNIV VA LCKG
|
Facility
|
IP
|
$2,666.65
|
|
| Hospital Charge Code |
270677659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$400.00
|
|
|
DRILL GUIDE 2.8MM VA W/CONE
|
Facility
|
OP
|
$2,450.35
|
|
| Hospital Charge Code |
270677606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.05 |
| Max. Negotiated Rate |
$1,225.17 |
| Rate for Payer: Aetna Commercial |
$931.13
|
| Rate for Payer: Aetna Medicare Advantage |
$735.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$624.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$624.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$624.84
|
| Rate for Payer: Cigna Commercial |
$1,225.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$735.11
|
| Rate for Payer: Oxford Commercial |
$490.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$367.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$490.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.93
|
|