|
SAW 33.5x6.4x0.6MM OFFSET LEFT
|
Facility
|
OP
|
$430.50
|
|
| Hospital Charge Code |
270674669
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$215.25 |
| Rate for Payer: Aetna Commercial |
$163.59
|
| Rate for Payer: Aetna Medicare Advantage |
$129.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$109.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$109.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$109.78
|
| Rate for Payer: Cigna Commercial |
$215.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.15
|
| Rate for Payer: Oxford Commercial |
$86.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$86.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.41
|
|
|
SAW 33.5x6.4x0.6MM OFFSET RT
|
Facility
|
OP
|
$430.50
|
|
| Hospital Charge Code |
270674668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$215.25 |
| Rate for Payer: Aetna Commercial |
$163.59
|
| Rate for Payer: Aetna Medicare Advantage |
$129.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$109.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$109.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$109.78
|
| Rate for Payer: Cigna Commercial |
$215.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.15
|
| Rate for Payer: Oxford Commercial |
$86.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$86.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.41
|
|
|
SAW 33.5x6.4x0.6MM OFFSET RT
|
Facility
|
IP
|
$430.50
|
|
| Hospital Charge Code |
270674668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.58 |
| Max. Negotiated Rate |
$64.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.58
|
|
|
SAW BLADE 10x10x0.4MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$121.03
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.55
|
| Rate for Payer: Oxford Commercial |
$63.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.44
|
|
|
SAW BLADE 10x10x0.4MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 10x10x0.4MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$126.35
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.75
|
| Rate for Payer: Oxford Commercial |
$66.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.81
|
|
|
SAW BLADE 10x10x0.4MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 10x25x0.6MM CUT
|
Facility
|
IP
|
$290.50
|
|
| Hospital Charge Code |
270674787
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$43.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
|
|
SAW BLADE 10x25x0.6MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 10x25x0.6MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$121.03
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.55
|
| Rate for Payer: Oxford Commercial |
$63.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.44
|
|
|
SAW BLADE 10x25x0.6MM CUT
|
Facility
|
OP
|
$290.50
|
|
| Hospital Charge Code |
270674787
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$145.25 |
| Rate for Payer: Aetna Commercial |
$110.39
|
| Rate for Payer: Aetna Medicare Advantage |
$87.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$74.08
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.15
|
| Rate for Payer: Oxford Commercial |
$58.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.70
|
|
|
SAW BLADE 10x25x0.6MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$126.35
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.75
|
| Rate for Payer: Oxford Commercial |
$66.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.81
|
|
|
SAW BLADE 10x25x0.6MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 10x30x0.4MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$121.03
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.55
|
| Rate for Payer: Oxford Commercial |
$63.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.44
|
|
|
SAW BLADE 10x30x0.4MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 10x30x0.4MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$126.35
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.75
|
| Rate for Payer: Oxford Commercial |
$66.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.81
|
|
|
SAW BLADE 10x30x0.4MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 10x50x0.6MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674829
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 10x50x0.6MM CUT
|
Facility
|
OP
|
$290.50
|
|
| Hospital Charge Code |
270674788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$145.25 |
| Rate for Payer: Aetna Commercial |
$110.39
|
| Rate for Payer: Aetna Medicare Advantage |
$87.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$74.08
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.15
|
| Rate for Payer: Oxford Commercial |
$58.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.70
|
|
|
SAW BLADE 10x50x0.6MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674829
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$121.03
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.55
|
| Rate for Payer: Oxford Commercial |
$63.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.44
|
|
|
SAW BLADE 10x50x0.6MM CUT
|
Facility
|
IP
|
$290.50
|
|
| Hospital Charge Code |
270674788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$43.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
|
|
SAW BLADE 10x50x0.6MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$126.35
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.75
|
| Rate for Payer: Oxford Commercial |
$66.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.81
|
|
|
SAW BLADE 10x50x0.6MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 12/25/2.5MM SHORT 45
|
Facility
|
IP
|
$1,172.50
|
|
| Hospital Charge Code |
270674843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.88 |
| Max. Negotiated Rate |
$175.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
|
|
SAW BLADE 12/25/2.5MM SHORT 45
|
Facility
|
OP
|
$1,172.50
|
|
| Hospital Charge Code |
270674843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.26 |
| Max. Negotiated Rate |
$586.25 |
| Rate for Payer: Aetna Commercial |
$445.55
|
| Rate for Payer: Aetna Medicare Advantage |
$351.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$298.99
|
| Rate for Payer: Cigna Commercial |
$586.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$351.75
|
| Rate for Payer: Oxford Commercial |
$234.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$234.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|