|
SAW BLADE 95MMx19MM 1.37MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674711
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx19MM 1.47MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx19MM 1.47MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 0.89MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674716
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 0.89MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674716
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx25MM 1.00MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx25MM 1.00MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 1.07MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx25MM 1.07MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 1.19MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674717
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx25MM 1.19MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674717
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 1.27MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674718
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 1.27MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674718
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx25MM 1.37MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674719
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE 95MMx25MM 1.37MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674719
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 1.47MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674720
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 95MMx25MM 1.47MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674720
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.50
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.20
|
|
|
SAW BLADE MICROAIRE NARROW
|
Facility
|
OP
|
$720.00
|
|
| Hospital Charge Code |
270670901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$273.60
|
| Rate for Payer: Aetna Medicare Advantage |
$216.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$183.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$183.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$183.60
|
| Rate for Payer: Cigna Commercial |
$360.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$216.00
|
| Rate for Payer: Oxford Commercial |
$144.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$144.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.08
|
|
|
SAW BLADE MICROAIRE NARROW
|
Facility
|
IP
|
$720.00
|
|
| Hospital Charge Code |
270670901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.00
|
|
|
SAW BLADE OXFORD CEMENTED
|
Facility
|
OP
|
$2,625.00
|
|
| Hospital Charge Code |
270684006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$1,312.50 |
| Rate for Payer: Aetna Commercial |
$997.50
|
| Rate for Payer: Aetna Medicare Advantage |
$787.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$669.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$669.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$669.38
|
| Rate for Payer: Cigna Commercial |
$1,312.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$787.50
|
| Rate for Payer: Oxford Commercial |
$525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$393.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$525.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$69.56
|
|
|
SAW BLADE OXFORD CEMENTED
|
Facility
|
IP
|
$2,625.00
|
|
| Hospital Charge Code |
270684006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$393.75 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$393.75
|
|
|
SAW BLADES
|
Facility
|
IP
|
$676.00
|
|
| Hospital Charge Code |
270332551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.40 |
| Max. Negotiated Rate |
$101.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$101.40
|
|
|
SAW BLADES
|
Facility
|
OP
|
$676.00
|
|
| Hospital Charge Code |
270332551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$256.88
|
| Rate for Payer: Aetna Medicare Advantage |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$172.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$172.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$172.38
|
| Rate for Payer: Cigna Commercial |
$338.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$202.80
|
| Rate for Payer: Oxford Commercial |
$135.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$101.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$135.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.91
|
|
|
SAWBLADE STR UNIV NARROW .315
|
Facility
|
IP
|
$915.00
|
|
| Hospital Charge Code |
270676925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.25 |
| Max. Negotiated Rate |
$137.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$137.25
|
|
|
SAWBLADE STR UNIV NARROW .315
|
Facility
|
OP
|
$915.00
|
|
| Hospital Charge Code |
270676925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.05 |
| Max. Negotiated Rate |
$457.50 |
| Rate for Payer: Aetna Commercial |
$347.70
|
| Rate for Payer: Aetna Medicare Advantage |
$274.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$233.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$233.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$233.32
|
| Rate for Payer: Cigna Commercial |
$457.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.50
|
| Rate for Payer: Oxford Commercial |
$183.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$137.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$183.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.25
|
|