|
REAMER METATARSAL 16MM
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270674086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$855.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$675.00
|
| Rate for Payer: Oxford Commercial |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$450.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59.62
|
|
|
REAMER METATARSAL 16MM
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270674086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
IP
|
$5,750.00
|
|
| Hospital Charge Code |
270669667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$862.50 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270674087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
OP
|
$5,750.00
|
|
| Hospital Charge Code |
270669667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.57 |
| Max. Negotiated Rate |
$2,875.00 |
| Rate for Payer: Aetna Commercial |
$2,185.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,466.25
|
| Rate for Payer: Cigna Commercial |
$2,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,725.00
|
| Rate for Payer: Oxford Commercial |
$1,150.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,150.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$138.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$152.38
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270674087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$855.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$675.00
|
| Rate for Payer: Oxford Commercial |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$450.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59.62
|
|
|
REAMER MODULAR 10.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 10.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 11.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 11.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 12.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 12.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 8.0MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 8.0MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 8.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 8.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 9.0MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 9.0MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 9.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.71
|
|
|
REAMER MODULAR 9.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MTP CUP 18MM GEN 2.455.
|
Facility
|
IP
|
$1,110.00
|
|
| Hospital Charge Code |
270702879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$268.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$244.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER MTP CUP 18MM GEN 2.455.
|
Facility
|
OP
|
$1,110.00
|
|
| Hospital Charge Code |
270702879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$421.80
|
| Rate for Payer: Aetna Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$283.05
|
| Rate for Payer: Cigna Commercial |
$555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$244.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.41
|
|
|
REAMER MTP CUP 20MM GEN 2.455.
|
Facility
|
OP
|
$1,110.00
|
|
| Hospital Charge Code |
270702880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$421.80
|
| Rate for Payer: Aetna Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$283.05
|
| Rate for Payer: Cigna Commercial |
$555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$244.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.41
|
|
|
REAMER MTP CUP 20MM GEN 2.455.
|
Facility
|
IP
|
$1,110.00
|
|
| Hospital Charge Code |
270702880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$268.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$244.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER ONE STEP 11.5mm
|
Facility
|
OP
|
$2,950.00
|
|
| Hospital Charge Code |
270646654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.09 |
| Max. Negotiated Rate |
$1,475.00 |
| Rate for Payer: Aetna Commercial |
$1,121.00
|
| Rate for Payer: Aetna Medicare Advantage |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.25
|
| Rate for Payer: Cigna Commercial |
$1,475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$885.00
|
| Rate for Payer: Oxford Commercial |
$590.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$442.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$590.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$78.17
|
|