|
BLADE LRG BONE 18.5x100x1.19mm
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270678715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
BLADE LRG BONE 18.5x90x1.27mm
|
Facility
|
OP
|
$233.70
|
|
| Hospital Charge Code |
270678716
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.63 |
| Max. Negotiated Rate |
$116.85 |
| Rate for Payer: Aetna Commercial |
$88.81
|
| Rate for Payer: Aetna Medicare Advantage |
$70.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.59
|
| Rate for Payer: Cigna Commercial |
$116.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$70.11
|
| Rate for Payer: Oxford Commercial |
$46.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.74
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.19
|
|
|
BLADE LRG BONE 18.5x90x1.27mm
|
Facility
|
IP
|
$233.70
|
|
| Hospital Charge Code |
270678716
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$35.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.05
|
|
|
BLADE LRG RASP TEAR 13X6.5MM
|
Facility
|
OP
|
$438.15
|
|
| Hospital Charge Code |
270701904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$219.07 |
| Rate for Payer: Aetna Commercial |
$166.50
|
| Rate for Payer: Aetna Medicare Advantage |
$131.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$111.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$111.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$111.73
|
| Rate for Payer: Cigna Commercial |
$219.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.44
|
| Rate for Payer: Oxford Commercial |
$87.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$87.63
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.61
|
|
|
BLADE LRG RASP TEAR 13X6.5MM
|
Facility
|
IP
|
$438.15
|
|
| Hospital Charge Code |
270701904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$65.72 |
| Max. Negotiated Rate |
$65.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.72
|
|
|
BLADE LVT MICRO SAG 5023-231
|
Facility
|
IP
|
$69.65
|
|
| Hospital Charge Code |
270624599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$10.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.45
|
|
|
BLADE LVT MICRO SAG 5023-231
|
Facility
|
OP
|
$69.65
|
|
| Hospital Charge Code |
270624599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$34.83 |
| Rate for Payer: Aetna Commercial |
$26.47
|
| Rate for Payer: Aetna Medicare Advantage |
$20.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.76
|
| Rate for Payer: Cigna Commercial |
$34.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.89
|
| Rate for Payer: Oxford Commercial |
$13.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.93
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.85
|
|
|
BLADE M-CLASS 1.27x13x90MM
|
Facility
|
OP
|
$322.10
|
|
| Hospital Charge Code |
270675402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$161.05 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Medicare Advantage |
$96.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.14
|
| Rate for Payer: Cigna Commercial |
$161.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.63
|
| Rate for Payer: Oxford Commercial |
$64.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$64.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.54
|
|
|
BLADE M-CLASS 1.27x13x90MM
|
Facility
|
IP
|
$322.10
|
|
| Hospital Charge Code |
270675402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$48.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.31
|
|
|
BLADE M-CLASS 1.27x19x90MM
|
Facility
|
IP
|
$322.10
|
|
| Hospital Charge Code |
270675401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$48.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.31
|
|
|
BLADE M-CLASS 1.27x19x90MM
|
Facility
|
OP
|
$322.10
|
|
| Hospital Charge Code |
270675401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$161.05 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Medicare Advantage |
$96.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.14
|
| Rate for Payer: Cigna Commercial |
$161.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.63
|
| Rate for Payer: Oxford Commercial |
$64.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$64.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.54
|
|
|
BLADE M-CLASS 1.27x25x90MM
|
Facility
|
IP
|
$322.10
|
|
| Hospital Charge Code |
270675403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$48.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.31
|
|
|
BLADE M-CLASS 1.27x25x90MM
|
Facility
|
OP
|
$322.10
|
|
| Hospital Charge Code |
270675403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$161.05 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Medicare Advantage |
$96.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.14
|
| Rate for Payer: Cigna Commercial |
$161.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.63
|
| Rate for Payer: Oxford Commercial |
$64.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$64.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.54
|
|
|
BLADE MICRO OSCILLATING
|
Facility
|
OP
|
$30.80
|
|
| Hospital Charge Code |
270651559
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$15.40 |
| Rate for Payer: Aetna Commercial |
$11.70
|
| Rate for Payer: Aetna Medicare Advantage |
$9.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.85
|
| Rate for Payer: Cigna Commercial |
$15.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.24
|
| Rate for Payer: Oxford Commercial |
$6.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.82
|
|
|
BLADE MICRO OSCILLATING
|
Facility
|
IP
|
$30.80
|
|
| Hospital Charge Code |
270651559
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$4.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.62
|
|
|
BLADE MICRO OSCILLATR 5053-267
|
Facility
|
OP
|
$79.00
|
|
| Hospital Charge Code |
1605070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$30.02
|
| Rate for Payer: Aetna Medicare Advantage |
$23.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.14
|
| Rate for Payer: Cigna Commercial |
$39.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.70
|
| Rate for Payer: Oxford Commercial |
$15.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.09
|
|
|
BLADE MICRO OSCILLATR 5053-267
|
Facility
|
IP
|
$79.00
|
|
| Hospital Charge Code |
1605070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.85 |
| Max. Negotiated Rate |
$11.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.85
|
|
|
BLADE MICRO SAGITTAL
|
Facility
|
OP
|
$33.50
|
|
| Hospital Charge Code |
270654634
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$16.75 |
| Rate for Payer: Aetna Commercial |
$12.73
|
| Rate for Payer: Aetna Medicare Advantage |
$10.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.54
|
| Rate for Payer: Cigna Commercial |
$16.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.05
|
| Rate for Payer: Oxford Commercial |
$6.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.03
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.89
|
|
|
BLADE MICRO SAGITTAL
|
Facility
|
IP
|
$33.50
|
|
| Hospital Charge Code |
270654634
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$5.03 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.03
|
|
|
BLADE MICRO SAGITTAL5.5X0.38MM
|
Facility
|
IP
|
$463.50
|
|
| Hospital Charge Code |
270691101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.53 |
| Max. Negotiated Rate |
$69.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.53
|
|
|
BLADE MICRO SAGITTAL5.5X0.38MM
|
Facility
|
OP
|
$463.50
|
|
| Hospital Charge Code |
270691101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$231.75 |
| Rate for Payer: Aetna Commercial |
$176.13
|
| Rate for Payer: Aetna Medicare Advantage |
$139.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$118.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$118.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$118.19
|
| Rate for Payer: Cigna Commercial |
$231.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.05
|
| Rate for Payer: Oxford Commercial |
$92.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$92.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.28
|
|
|
BLADE MICRO SAGITTAL FINE
|
Facility
|
OP
|
$67.85
|
|
| Hospital Charge Code |
270690395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$33.92 |
| Rate for Payer: Aetna Commercial |
$25.78
|
| Rate for Payer: Aetna Medicare Advantage |
$20.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.30
|
| Rate for Payer: Cigna Commercial |
$33.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.36
|
| Rate for Payer: Oxford Commercial |
$13.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.80
|
|
|
BLADE MICRO SAGITTAL FINE
|
Facility
|
IP
|
$67.85
|
|
| Hospital Charge Code |
270690395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$10.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.18
|
|
|
BLADE MICROSHARP 75
|
Facility
|
IP
|
$26.45
|
|
| Hospital Charge Code |
270601025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.97
|
|
|
BLADE MICROSHARP 75
|
Facility
|
OP
|
$26.45
|
|
| Hospital Charge Code |
270601025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$13.22 |
| Rate for Payer: Aetna Commercial |
$10.05
|
| Rate for Payer: Aetna Medicare Advantage |
$7.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.74
|
| Rate for Payer: Cigna Commercial |
$13.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.93
|
| Rate for Payer: Oxford Commercial |
$5.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.70
|
|