|
SUTURETAPE W/TAILS 1.3MM
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
270677469
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
SUTURETAPE W/TAILS 1.3MM
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
270677469
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna Commercial |
$66.50
|
| Rate for Payer: Aetna Medicare Advantage |
$52.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.62
|
| Rate for Payer: Cigna Commercial |
$87.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$52.50
|
| Rate for Payer: Oxford Commercial |
$35.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$35.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.64
|
|
|
SUTURE TENSIONER CUTTER FOR
|
Facility
|
OP
|
$875.00
|
|
| Hospital Charge Code |
270690984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna Commercial |
$332.50
|
| Rate for Payer: Aetna Medicare Advantage |
$262.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.12
|
| Rate for Payer: Cigna Commercial |
$437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$262.50
|
| Rate for Payer: Oxford Commercial |
$175.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.19
|
|
|
SUTURE TENSIONER CUTTER FOR
|
Facility
|
IP
|
$875.00
|
|
| Hospital Charge Code |
270690984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.25
|
|
|
SUTURE TICRON 1 30 BLUE CT1
|
Facility
|
OP
|
$7.19
|
|
| Hospital Charge Code |
270651244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: Aetna Medicare Advantage |
$2.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.83
|
| Rate for Payer: Cigna Commercial |
$3.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.16
|
| Rate for Payer: Oxford Commercial |
$1.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
SUTURE TICRON 1 30 BLUE CT1
|
Facility
|
IP
|
$7.19
|
|
| Hospital Charge Code |
270651244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$1.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.08
|
|
|
SUTURE TICRON 2/0 30 BLUE C15
|
Facility
|
OP
|
$5.66
|
|
| Hospital Charge Code |
270604638
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.15
|
| Rate for Payer: Aetna Medicare Advantage |
$1.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.44
|
| Rate for Payer: Cigna Commercial |
$2.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.70
|
| Rate for Payer: Oxford Commercial |
$1.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.15
|
|
|
SUTURE TICRON 2/0 30 BLUE C15
|
Facility
|
IP
|
$5.66
|
|
| Hospital Charge Code |
270604638
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
|
|
SUTURE TICRON 2-0 V-20 NDL
|
Facility
|
IP
|
$4.69
|
|
| Hospital Charge Code |
270644589
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$0.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.70
|
|
|
SUTURE TICRON 2-0 V-20 NDL
|
Facility
|
OP
|
$4.69
|
|
| Hospital Charge Code |
270644589
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$2.35 |
| Rate for Payer: Aetna Commercial |
$1.78
|
| Rate for Payer: Aetna Medicare Advantage |
$1.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.20
|
| Rate for Payer: Cigna Commercial |
$2.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.41
|
| Rate for Payer: Oxford Commercial |
$0.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.94
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.12
|
|
|
SUTURE TICRON 2 30 BLUE HOS10
|
Facility
|
IP
|
$10.05
|
|
| Hospital Charge Code |
270656049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.51
|
|
|
SUTURE TICRON 2 30 BLUE HOS10
|
Facility
|
OP
|
$10.05
|
|
| Hospital Charge Code |
270656049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$5.03 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: Aetna Medicare Advantage |
$3.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.56
|
| Rate for Payer: Cigna Commercial |
$5.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.02
|
| Rate for Payer: Oxford Commercial |
$2.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.01
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.27
|
|
|
SUTURE TICRON 3/0 36 BLU CV3
|
Facility
|
OP
|
$21.06
|
|
| Hospital Charge Code |
270651248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$10.53 |
| Rate for Payer: Aetna Commercial |
$8.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.37
|
| Rate for Payer: Cigna Commercial |
$10.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.32
|
| Rate for Payer: Oxford Commercial |
$4.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.56
|
|
|
SUTURE TICRON 3/0 36 BLU CV3
|
Facility
|
IP
|
$21.06
|
|
| Hospital Charge Code |
270651248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$3.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.16
|
|
|
SUTURE TICRON 4/0 30 BLUE C12
|
Facility
|
OP
|
$5.30
|
|
| Hospital Charge Code |
270604647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$2.65 |
| Rate for Payer: Aetna Commercial |
$2.01
|
| Rate for Payer: Aetna Medicare Advantage |
$1.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.35
|
| Rate for Payer: Cigna Commercial |
$2.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.59
|
| Rate for Payer: Oxford Commercial |
$1.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.06
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.14
|
|
|
SUTURE TICRON 4/0 30 BLUE C12
|
Facility
|
IP
|
$5.30
|
|
| Hospital Charge Code |
270604647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.80
|
|
|
SUTURE TICRON 5-0 BLUE 18 INCH
|
Facility
|
IP
|
$9.06
|
|
| Hospital Charge Code |
270651350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$1.36 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.36
|
|
|
SUTURE TICRON 5-0 BLUE 18 INCH
|
Facility
|
OP
|
$9.06
|
|
| Hospital Charge Code |
270651350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$4.53 |
| Rate for Payer: Aetna Commercial |
$3.44
|
| Rate for Payer: Aetna Medicare Advantage |
$2.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.31
|
| Rate for Payer: Cigna Commercial |
$4.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.72
|
| Rate for Payer: Oxford Commercial |
$1.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
SUTURE TICRON 5 30 BLUE GS18
|
Facility
|
OP
|
$13.41
|
|
| Hospital Charge Code |
270661495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$6.71 |
| Rate for Payer: Aetna Commercial |
$5.10
|
| Rate for Payer: Aetna Medicare Advantage |
$4.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.42
|
| Rate for Payer: Cigna Commercial |
$6.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.02
|
| Rate for Payer: Oxford Commercial |
$2.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
SUTURE TICRON 5 30 BLUE GS18
|
Facility
|
IP
|
$13.41
|
|
| Hospital Charge Code |
270661495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$2.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.01
|
|
|
SUTURE TICRON 5 BLUE 30 T-56
|
Facility
|
OP
|
$10.30
|
|
| Hospital Charge Code |
270665643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$5.15 |
| Rate for Payer: Aetna Commercial |
$3.91
|
| Rate for Payer: Aetna Medicare Advantage |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.63
|
| Rate for Payer: Cigna Commercial |
$5.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.09
|
| Rate for Payer: Oxford Commercial |
$2.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.06
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.27
|
|
|
SUTURE TICRON 5 BLUE 30 T-56
|
Facility
|
IP
|
$10.30
|
|
| Hospital Charge Code |
270665643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$1.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.54
|
|
|
SUTURE TICRON COATED BRAIDED
|
Facility
|
IP
|
$7.26
|
|
| Hospital Charge Code |
270651243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$1.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.09
|
|
|
SUTURE TICRON COATED BRAIDED
|
Facility
|
IP
|
$12.55
|
|
| Hospital Charge Code |
270651247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
|
|
SUTURE TICRON COATED BRAIDED
|
Facility
|
OP
|
$12.55
|
|
| Hospital Charge Code |
270651247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$6.28 |
| Rate for Payer: Aetna Commercial |
$4.77
|
| Rate for Payer: Aetna Medicare Advantage |
$3.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.20
|
| Rate for Payer: Cigna Commercial |
$6.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.77
|
| Rate for Payer: Oxford Commercial |
$2.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.33
|
|