|
DRILL LONG
|
Facility
|
OP
|
$1,070.00
|
|
| Hospital Charge Code |
270677456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.79 |
| Max. Negotiated Rate |
$535.00 |
| Rate for Payer: Aetna Commercial |
$406.60
|
| Rate for Payer: Aetna Medicare Advantage |
$321.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$272.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$272.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$272.85
|
| Rate for Payer: Cigna Commercial |
$535.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$321.00
|
| Rate for Payer: Oxford Commercial |
$214.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$214.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.36
|
|
|
DRILL LONG 4.3
|
Facility
|
OP
|
$1,164.35
|
|
| Hospital Charge Code |
270673792
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$582.17 |
| Rate for Payer: Aetna Commercial |
$442.45
|
| Rate for Payer: Aetna Medicare Advantage |
$349.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$296.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$296.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$296.91
|
| Rate for Payer: Cigna Commercial |
$582.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$349.31
|
| Rate for Payer: Oxford Commercial |
$232.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$174.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$232.87
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.86
|
|
|
DRILL LONG 4.3
|
Facility
|
IP
|
$1,164.35
|
|
| Hospital Charge Code |
270673792
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.65 |
| Max. Negotiated Rate |
$174.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$174.65
|
|
|
DRILL MAZOR LONG 3.0X30MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270698621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
DRILL MAZOR LONG 3.0X30MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270698621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.91 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.49
|
|
|
DRILL MAZOR SHORT 3.0X30MM
|
Facility
|
IP
|
$850.00
|
|
| Hospital Charge Code |
270698622
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.50 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$127.50
|
|
|
DRILL MAZOR SHORT 3.0X30MM
|
Facility
|
OP
|
$850.00
|
|
| Hospital Charge Code |
270698622
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.48 |
| Max. Negotiated Rate |
$425.00 |
| Rate for Payer: Aetna Commercial |
$323.00
|
| Rate for Payer: Aetna Medicare Advantage |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$216.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$216.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$216.75
|
| Rate for Payer: Cigna Commercial |
$425.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$255.00
|
| Rate for Payer: Oxford Commercial |
$170.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$127.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$170.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.52
|
|
|
DRILL MAZOR XLONG 3.0X80MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270698626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
DRILL MAZOR XLONG 3.0X80MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270698626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.91 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.49
|
|
|
DRILL MAZOR XLONG 4X80MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270698625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.91 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.49
|
|
|
DRILL MAZOR XLONG 4X80MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270698625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
DRILL NANOTACK FLEX 1.4 MM
|
Facility
|
IP
|
$795.00
|
|
| Hospital Charge Code |
270680574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.25 |
| Max. Negotiated Rate |
$119.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.25
|
|
|
DRILL NANOTACK FLEX 1.4 MM
|
Facility
|
OP
|
$795.00
|
|
| Hospital Charge Code |
270680574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$397.50 |
| Rate for Payer: Aetna Commercial |
$302.10
|
| Rate for Payer: Aetna Medicare Advantage |
$238.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$202.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$202.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$202.72
|
| Rate for Payer: Cigna Commercial |
$397.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$238.50
|
| Rate for Payer: Oxford Commercial |
$159.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.07
|
|
|
DRILL NEURO 3.0 MM
|
Facility
|
OP
|
$392.85
|
|
| Hospital Charge Code |
270703078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$196.43 |
| Rate for Payer: Aetna Commercial |
$149.28
|
| Rate for Payer: Aetna Medicare Advantage |
$117.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.18
|
| Rate for Payer: Cigna Commercial |
$196.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.86
|
| Rate for Payer: Oxford Commercial |
$78.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$78.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.41
|
|
|
DRILL NEURO 3.0 MM
|
Facility
|
IP
|
$392.85
|
|
| Hospital Charge Code |
270703078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.93 |
| Max. Negotiated Rate |
$58.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.93
|
|
|
DRILL NEURO 3.0X3.8MM
|
Facility
|
IP
|
$757.55
|
|
| Hospital Charge Code |
270692062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.63 |
| Max. Negotiated Rate |
$113.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$113.63
|
|
|
DRILL NEURO 3.0X3.8MM
|
Facility
|
OP
|
$757.55
|
|
| Hospital Charge Code |
270692062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$378.77 |
| Rate for Payer: Aetna Commercial |
$287.87
|
| Rate for Payer: Aetna Medicare Advantage |
$227.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$193.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$193.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$193.18
|
| Rate for Payer: Cigna Commercial |
$378.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$227.26
|
| Rate for Payer: Oxford Commercial |
$151.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$113.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$151.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.08
|
|
|
DRILL NEURO SPIRAL (BLADE)
|
Facility
|
IP
|
$484.00
|
|
| Hospital Charge Code |
270335146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.60 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
|
|
DRILL NEURO SPIRAL (BLADE)
|
Facility
|
OP
|
$484.00
|
|
| Hospital Charge Code |
270335146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$242.00 |
| Rate for Payer: Aetna Commercial |
$183.92
|
| Rate for Payer: Aetna Medicare Advantage |
$145.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$123.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$123.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$123.42
|
| Rate for Payer: Cigna Commercial |
$242.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.20
|
| Rate for Payer: Oxford Commercial |
$96.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$96.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.83
|
|
|
DRILL OBLIQUE 4.2X250MM
|
Facility
|
OP
|
$1,505.00
|
|
| Hospital Charge Code |
270670456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$752.50 |
| Rate for Payer: Aetna Commercial |
$571.90
|
| Rate for Payer: Aetna Medicare Advantage |
$451.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$383.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$383.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$383.77
|
| Rate for Payer: Cigna Commercial |
$752.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$451.50
|
| Rate for Payer: Oxford Commercial |
$301.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.88
|
|
|
DRILL OBLIQUE 4.2X250MM
|
Facility
|
IP
|
$1,505.00
|
|
| Hospital Charge Code |
270670456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.75 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.75
|
|
|
DRILL PEG INBONE TALAR 4MM
|
Facility
|
IP
|
$455.00
|
|
| Hospital Charge Code |
270676976
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$68.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.25
|
|
|
DRILL PEG INBONE TALAR 4MM
|
Facility
|
OP
|
$455.00
|
|
| Hospital Charge Code |
270676976
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna Commercial |
$172.90
|
| Rate for Payer: Aetna Medicare Advantage |
$136.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$116.03
|
| Rate for Payer: Cigna Commercial |
$227.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$136.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$91.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.06
|
|
|
DRILL PILOT 1.7MM
|
Facility
|
IP
|
$1,650.00
|
|
| Hospital Charge Code |
270673753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$247.50 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$247.50
|
|
|
DRILL PILOT 1.7MM
|
Facility
|
OP
|
$1,650.00
|
|
| Hospital Charge Code |
270673753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.77 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: Aetna Commercial |
$627.00
|
| Rate for Payer: Aetna Medicare Advantage |
$495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$420.75
|
| Rate for Payer: Cigna Commercial |
$825.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$495.00
|
| Rate for Payer: Oxford Commercial |
$330.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$247.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$330.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.73
|
|