|
STRUT FIBULAR 10CM LONG
|
Facility
|
OP
|
$4,400.00
|
|
| Hospital Charge Code |
270663749
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$1,672.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,320.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,122.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,122.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,122.00
|
| Rate for Payer: Cigna Commercial |
$2,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,320.00
|
| Rate for Payer: Oxford Commercial |
$880.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$660.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$880.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$106.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$116.60
|
|
|
STRUT MAXFRAME MEDIUM
|
Facility
|
OP
|
$5,559.90
|
|
| Hospital Charge Code |
270691899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.99 |
| Max. Negotiated Rate |
$2,779.95 |
| Rate for Payer: Aetna Commercial |
$2,112.76
|
| Rate for Payer: Aetna Medicare Advantage |
$1,667.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,417.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,417.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,417.77
|
| Rate for Payer: Cigna Commercial |
$2,779.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.97
|
| Rate for Payer: Oxford Commercial |
$1,111.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$833.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,111.98
|
| Rate for Payer: UnitedHealthcare Community & State |
$133.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$147.34
|
|
|
STRUT MAXFRAME MEDIUM
|
Facility
|
IP
|
$5,559.90
|
|
| Hospital Charge Code |
270691899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$833.99 |
| Max. Negotiated Rate |
$833.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$833.99
|
|
|
STRUT MTF FEMORAL CORT 550486
|
Facility
|
IP
|
$2,995.90
|
|
| Hospital Charge Code |
270627392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$449.38 |
| Max. Negotiated Rate |
$449.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$449.38
|
|
|
STRUT MTF FEMORAL CORT 550486
|
Facility
|
OP
|
$2,995.90
|
|
| Hospital Charge Code |
270627392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.20 |
| Max. Negotiated Rate |
$1,497.95 |
| Rate for Payer: Aetna Commercial |
$1,138.44
|
| Rate for Payer: Aetna Medicare Advantage |
$898.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$763.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$763.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$763.95
|
| Rate for Payer: Cigna Commercial |
$1,497.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$898.77
|
| Rate for Payer: Oxford Commercial |
$599.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$449.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$599.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$72.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$79.39
|
|
|
STRUT QUICK ADJUST-X SHORT
|
Facility
|
OP
|
$6,657.00
|
|
| Hospital Charge Code |
270683947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.43 |
| Max. Negotiated Rate |
$3,328.50 |
| Rate for Payer: Aetna Commercial |
$2,529.66
|
| Rate for Payer: Aetna Medicare Advantage |
$1,997.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,697.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,697.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,697.54
|
| Rate for Payer: Cigna Commercial |
$3,328.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,997.10
|
| Rate for Payer: Oxford Commercial |
$1,331.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$998.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,331.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$160.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$176.41
|
|
|
STRUT QUICK ADJUST-X SHORT
|
Facility
|
OP
|
$6,657.00
|
|
| Hospital Charge Code |
270683946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.43 |
| Max. Negotiated Rate |
$3,328.50 |
| Rate for Payer: Aetna Commercial |
$2,529.66
|
| Rate for Payer: Aetna Medicare Advantage |
$1,997.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,697.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,697.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,697.54
|
| Rate for Payer: Cigna Commercial |
$3,328.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,997.10
|
| Rate for Payer: Oxford Commercial |
$1,331.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$998.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,331.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$160.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$176.41
|
|
|
STRUT QUICK ADJUST-X SHORT
|
Facility
|
IP
|
$6,657.00
|
|
| Hospital Charge Code |
270683947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$998.55 |
| Max. Negotiated Rate |
$998.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$998.55
|
|
|
STRUT QUICK ADJUST-X SHORT
|
Facility
|
IP
|
$6,657.00
|
|
| Hospital Charge Code |
270683946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$998.55 |
| Max. Negotiated Rate |
$998.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$998.55
|
|
|
STRUTS MEDIUM
|
Facility
|
IP
|
$6,565.00
|
|
| Hospital Charge Code |
270684450
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$984.75 |
| Max. Negotiated Rate |
$984.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$984.75
|
|
|
STRUTS MEDIUM
|
Facility
|
OP
|
$6,565.00
|
|
| Hospital Charge Code |
270684450
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.22 |
| Max. Negotiated Rate |
$3,282.50 |
| Rate for Payer: Aetna Commercial |
$2,494.70
|
| Rate for Payer: Aetna Medicare Advantage |
$1,969.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,674.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,674.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,674.08
|
| Rate for Payer: Cigna Commercial |
$3,282.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,969.50
|
| Rate for Payer: Oxford Commercial |
$1,313.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$984.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,313.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$158.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$173.97
|
|
|
STRUT X SHORT STANDARD MAX
|
Facility
|
IP
|
$6,471.00
|
|
| Hospital Charge Code |
270681228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$970.65 |
| Max. Negotiated Rate |
$970.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$970.65
|
|
|
STRUT X SHORT STANDARD MAX
|
Facility
|
OP
|
$6,471.00
|
|
| Hospital Charge Code |
270681228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$155.95 |
| Max. Negotiated Rate |
$3,235.50 |
| Rate for Payer: Aetna Commercial |
$2,458.98
|
| Rate for Payer: Aetna Medicare Advantage |
$1,941.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,650.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,650.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,650.11
|
| Rate for Payer: Cigna Commercial |
$3,235.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,941.30
|
| Rate for Payer: Oxford Commercial |
$1,294.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$970.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,294.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$155.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$171.48
|
|
|
STR WEIL BLAKESLEY THUCUT
|
Facility
|
OP
|
$3,432.65
|
|
| Hospital Charge Code |
270689939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$82.73 |
| Max. Negotiated Rate |
$1,716.33 |
| Rate for Payer: Aetna Commercial |
$1,304.41
|
| Rate for Payer: Aetna Medicare Advantage |
$1,029.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$875.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$875.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$875.33
|
| Rate for Payer: Cigna Commercial |
$1,716.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,029.80
|
| Rate for Payer: Oxford Commercial |
$686.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$514.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$82.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$90.97
|
|
|
STR WEIL BLAKESLEY THUCUT
|
Facility
|
IP
|
$3,432.65
|
|
| Hospital Charge Code |
270689939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$514.90 |
| Max. Negotiated Rate |
$514.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$514.90
|
|
|
STRYKER 266-628 25MM MICRO****
|
Facility
|
IP
|
$216.00
|
|
| Hospital Charge Code |
1607266
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
|
|
STRYKER 266-628 25MM MICRO****
|
Facility
|
OP
|
$216.00
|
|
| Hospital Charge Code |
1607266
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare Advantage |
$64.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55.08
|
| Rate for Payer: Cigna Commercial |
$108.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.80
|
| Rate for Payer: Oxford Commercial |
$43.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$43.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.72
|
|
|
STRYKER 266-638 35 MM MICRO***
|
Facility
|
IP
|
$216.00
|
|
| Hospital Charge Code |
1607274
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
|
|
STRYKER 266-638 35 MM MICRO***
|
Facility
|
OP
|
$216.00
|
|
| Hospital Charge Code |
1607274
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare Advantage |
$64.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55.08
|
| Rate for Payer: Cigna Commercial |
$108.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.80
|
| Rate for Payer: Oxford Commercial |
$43.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$43.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.72
|
|
|
STRYKER 266-648 4.0MM MICRO***
|
Facility
|
IP
|
$216.00
|
|
| Hospital Charge Code |
1607282
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
|
|
STRYKER 266-648 4.0MM MICRO***
|
Facility
|
OP
|
$216.00
|
|
| Hospital Charge Code |
1607282
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare Advantage |
$64.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55.08
|
| Rate for Payer: Cigna Commercial |
$108.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.80
|
| Rate for Payer: Oxford Commercial |
$43.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$43.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.72
|
|
|
STRYKER 266 744,4.0MM MICRO***
|
Facility
|
IP
|
$232.00
|
|
| Hospital Charge Code |
1607290
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$34.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.80
|
|
|
STRYKER 266 744,4.0MM MICRO***
|
Facility
|
OP
|
$232.00
|
|
| Hospital Charge Code |
1607290
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$116.00 |
| Rate for Payer: Aetna Commercial |
$88.16
|
| Rate for Payer: Aetna Medicare Advantage |
$69.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.16
|
| Rate for Payer: Cigna Commercial |
$116.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.60
|
| Rate for Payer: Oxford Commercial |
$46.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.15
|
|
|
STRYKER 275-531 35MM COUGAR***
|
Facility
|
OP
|
$207.00
|
|
| Hospital Charge Code |
1607233
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$4.99 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$78.66
|
| Rate for Payer: Aetna Medicare Advantage |
$62.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.78
|
| Rate for Payer: Cigna Commercial |
$103.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$62.10
|
| Rate for Payer: Oxford Commercial |
$41.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$41.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.49
|
|
|
STRYKER 275-531 35MM COUGAR***
|
Facility
|
IP
|
$207.00
|
|
| Hospital Charge Code |
1607233
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
|