|
NEEDLE SPINAL 18G THINWALL
|
Facility
|
OP
|
$63.25
|
|
| Hospital Charge Code |
270606021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$24.04
|
| Rate for Payer: Aetna Medicare Advantage |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.13
|
| Rate for Payer: Cigna Commercial |
$31.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.98
|
| Rate for Payer: Oxford Commercial |
$12.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.68
|
|
|
NEEDLE SPINAL 18G THINWALL
|
Facility
|
IP
|
$63.25
|
|
| Hospital Charge Code |
270606021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.49 |
| Max. Negotiated Rate |
$9.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.49
|
|
|
NEEDLE SPINAL 18Gx180mm
|
Facility
|
IP
|
$85.00
|
|
| Hospital Charge Code |
270674011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$12.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.75
|
|
|
NEEDLE SPINAL 18Gx180mm
|
Facility
|
OP
|
$85.00
|
|
| Hospital Charge Code |
270674011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Aetna Commercial |
$32.30
|
| Rate for Payer: Aetna Medicare Advantage |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.68
|
| Rate for Payer: Cigna Commercial |
$42.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.50
|
| Rate for Payer: Oxford Commercial |
$17.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.25
|
|
|
NEEDLE SPINAL 18G X 3
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
270331657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$5.70
|
| Rate for Payer: Aetna Medicare Advantage |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.83
|
| Rate for Payer: Cigna Commercial |
$7.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.50
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.40
|
|
|
NEEDLE SPINAL 18G X 3
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
270331657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
|
|
NEEDLE SPINAL 20G/1 1/2
|
Facility
|
IP
|
$8.61
|
|
| Hospital Charge Code |
270020062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
NEEDLE SPINAL 20G/1 1/2
|
Facility
|
OP
|
$8.61
|
|
| Hospital Charge Code |
270020062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.30 |
| Rate for Payer: Aetna Commercial |
$3.27
|
| Rate for Payer: Aetna Medicare Advantage |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.58
|
| Rate for Payer: Oxford Commercial |
$1.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
NEEDLE SPINAL 20G 1.5 DISP.
|
Facility
|
OP
|
$7.65
|
|
| Hospital Charge Code |
270649429
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$3.83 |
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare Advantage |
$2.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.95
|
| Rate for Payer: Cigna Commercial |
$3.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.29
|
| Rate for Payer: Oxford Commercial |
$1.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.20
|
|
|
NEEDLE SPINAL 20G 1.5 DISP.
|
Facility
|
IP
|
$7.65
|
|
| Hospital Charge Code |
270649429
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$1.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.15
|
|
|
NEEDLE SPINAL 20G/3 1/2
|
Facility
|
IP
|
$7.60
|
|
| Hospital Charge Code |
270020063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$1.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.14
|
|
|
NEEDLE SPINAL 20G/3 1/2
|
Facility
|
OP
|
$7.60
|
|
| Hospital Charge Code |
270020063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$3.80 |
| Rate for Payer: Aetna Commercial |
$2.89
|
| Rate for Payer: Aetna Medicare Advantage |
$2.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.94
|
| Rate for Payer: Cigna Commercial |
$3.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.28
|
| Rate for Payer: Oxford Commercial |
$1.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.52
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.20
|
|
|
NEEDLE SPINAL 20G 3.5 405182
|
Facility
|
IP
|
$6.64
|
|
| Hospital Charge Code |
27020063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
|
|
NEEDLE SPINAL 20G 3.5 405182
|
Facility
|
OP
|
$6.64
|
|
| Hospital Charge Code |
27020063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$3.32 |
| Rate for Payer: Aetna Commercial |
$2.52
|
| Rate for Payer: Aetna Medicare Advantage |
$1.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.69
|
| Rate for Payer: Cigna Commercial |
$3.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.99
|
| Rate for Payer: Oxford Commercial |
$1.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.33
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.18
|
|
|
NEEDLE SPINAL 20G 6 405211
|
Facility
|
IP
|
$17.15
|
|
| Hospital Charge Code |
270632105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.57
|
|
|
NEEDLE SPINAL 20G 6 405211
|
Facility
|
OP
|
$17.15
|
|
| Hospital Charge Code |
270632105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$8.57 |
| Rate for Payer: Aetna Commercial |
$6.52
|
| Rate for Payer: Aetna Medicare Advantage |
$5.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.37
|
| Rate for Payer: Cigna Commercial |
$8.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.14
|
| Rate for Payer: Oxford Commercial |
$3.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
NEEDLE SPINAL 21G DSN-10CMT
|
Facility
|
IP
|
$147.25
|
|
| Hospital Charge Code |
270600456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.09 |
| Max. Negotiated Rate |
$22.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.09
|
|
|
NEEDLE SPINAL 21G DSN-10CMT
|
Facility
|
OP
|
$147.25
|
|
| Hospital Charge Code |
270600456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$73.62 |
| Rate for Payer: Aetna Commercial |
$55.95
|
| Rate for Payer: Aetna Medicare Advantage |
$44.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.55
|
| Rate for Payer: Cigna Commercial |
$73.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.17
|
| Rate for Payer: Oxford Commercial |
$29.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$29.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.90
|
|
|
NEEDLE SPINAL 22G 1.5 BLACK
|
Facility
|
OP
|
$7.84
|
|
| Hospital Charge Code |
270650250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Aetna Commercial |
$2.98
|
| Rate for Payer: Aetna Medicare Advantage |
$2.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.00
|
| Rate for Payer: Cigna Commercial |
$3.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.35
|
| Rate for Payer: Oxford Commercial |
$1.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.21
|
|
|
NEEDLE SPINAL 22G 1.5 BLACK
|
Facility
|
IP
|
$7.84
|
|
| Hospital Charge Code |
270650250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$1.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.18
|
|
|
NEEDLE SPINAL 22G/2 1/2 DMD PT
|
Facility
|
OP
|
$24.85
|
|
| Hospital Charge Code |
270603378
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$12.43 |
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna Medicare Advantage |
$7.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.34
|
| Rate for Payer: Cigna Commercial |
$12.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.46
|
| Rate for Payer: Oxford Commercial |
$4.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.66
|
|
|
NEEDLE SPINAL 22G/2 1/2 DMD PT
|
Facility
|
IP
|
$24.85
|
|
| Hospital Charge Code |
270603378
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$3.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.73
|
|
|
NEEDLE SPINAL 22G/3
|
Facility
|
OP
|
$16.85
|
|
| Hospital Charge Code |
270020170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$8.43 |
| Rate for Payer: Aetna Commercial |
$6.40
|
| Rate for Payer: Aetna Medicare Advantage |
$5.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.30
|
| Rate for Payer: Cigna Commercial |
$8.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.05
|
| Rate for Payer: Oxford Commercial |
$3.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
NEEDLE SPINAL 22G/3
|
Facility
|
IP
|
$16.85
|
|
| Hospital Charge Code |
270020170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.53
|
|
|
NEEDLE SPINAL 22G/3 1/2
|
Facility
|
OP
|
$7.60
|
|
| Hospital Charge Code |
270020065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$3.80 |
| Rate for Payer: Aetna Commercial |
$2.89
|
| Rate for Payer: Aetna Medicare Advantage |
$2.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.94
|
| Rate for Payer: Cigna Commercial |
$3.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.28
|
| Rate for Payer: Oxford Commercial |
$1.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.52
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.20
|
|