|
BLADE SAW SAGITTAL 25x9x.51MM
|
Facility
|
IP
|
$95.65
|
|
| Hospital Charge Code |
270673036
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$14.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.35
|
|
|
BLADE SAW SAGITTAL 25x9x.51MM
|
Facility
|
OP
|
$95.65
|
|
| Hospital Charge Code |
270673036
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$47.83 |
| Rate for Payer: Aetna Commercial |
$36.35
|
| Rate for Payer: Aetna Medicare Advantage |
$28.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.39
|
| Rate for Payer: Cigna Commercial |
$47.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.70
|
| Rate for Payer: Oxford Commercial |
$19.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.53
|
|
|
BLADE SAW SAGITTAL 31x9MM
|
Facility
|
IP
|
$96.45
|
|
| Hospital Charge Code |
270673576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.47 |
| Max. Negotiated Rate |
$14.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.47
|
|
|
BLADE SAW SAGITTAL 31x9MM
|
Facility
|
OP
|
$96.45
|
|
| Hospital Charge Code |
270673576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.32 |
| Max. Negotiated Rate |
$48.23 |
| Rate for Payer: Aetna Commercial |
$36.65
|
| Rate for Payer: Aetna Medicare Advantage |
$28.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.59
|
| Rate for Payer: Cigna Commercial |
$48.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.93
|
| Rate for Payer: Oxford Commercial |
$19.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.56
|
|
|
BLADE SAW SAGITTAL 40x19.5MM
|
Facility
|
IP
|
$118.65
|
|
| Hospital Charge Code |
270675967
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$17.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.80
|
|
|
BLADE SAW SAGITTAL 40x19.5MM
|
Facility
|
OP
|
$118.65
|
|
| Hospital Charge Code |
270675967
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$59.33 |
| Rate for Payer: Aetna Commercial |
$45.09
|
| Rate for Payer: Aetna Medicare Advantage |
$35.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.26
|
| Rate for Payer: Cigna Commercial |
$59.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.59
|
| Rate for Payer: Oxford Commercial |
$23.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.14
|
|
|
BLADE SAW STERNUM 32MM
|
Facility
|
IP
|
$52.35
|
|
| Hospital Charge Code |
270662338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.85 |
| Max. Negotiated Rate |
$7.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.85
|
|
|
BLADE SAW STERNUM 32MM
|
Facility
|
OP
|
$52.35
|
|
| Hospital Charge Code |
270662338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$26.18 |
| Rate for Payer: Aetna Commercial |
$19.89
|
| Rate for Payer: Aetna Medicare Advantage |
$15.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.35
|
| Rate for Payer: Cigna Commercial |
$26.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.71
|
| Rate for Payer: Oxford Commercial |
$10.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.39
|
|
|
BLADE SAW WIDE .5 INCH
|
Facility
|
OP
|
$1,665.00
|
|
| Hospital Charge Code |
270693696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Aetna Commercial |
$632.70
|
| Rate for Payer: Aetna Medicare Advantage |
$499.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.57
|
| Rate for Payer: Cigna Commercial |
$832.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$499.50
|
| Rate for Payer: Oxford Commercial |
$333.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$333.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$40.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$44.12
|
|
|
BLADE SAW WIDE .5 INCH
|
Facility
|
IP
|
$1,665.00
|
|
| Hospital Charge Code |
270693696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.75 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.75
|
|
|
BLADE SCALPEL 20MM STD
|
Facility
|
OP
|
$2,025.00
|
|
| Hospital Charge Code |
270684398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$769.50
|
| Rate for Payer: Aetna Medicare Advantage |
$607.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.38
|
| Rate for Payer: Cigna Commercial |
$1,012.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$607.50
|
| Rate for Payer: Oxford Commercial |
$405.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$405.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.66
|
|
|
BLADE SCALPEL 20MM STD
|
Facility
|
IP
|
$2,025.00
|
|
| Hospital Charge Code |
270684398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
BLADE SCLERATOME MULTI-SIDED
|
Facility
|
IP
|
$52.30
|
|
| Hospital Charge Code |
270651004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$7.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.84
|
|
|
BLADE SCLERATOME MULTI-SIDED
|
Facility
|
OP
|
$52.30
|
|
| Hospital Charge Code |
270651004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$26.15 |
| Rate for Payer: Aetna Commercial |
$19.87
|
| Rate for Payer: Aetna Medicare Advantage |
$15.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.34
|
| Rate for Payer: Cigna Commercial |
$26.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.69
|
| Rate for Payer: Oxford Commercial |
$10.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.46
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.39
|
|
|
BLADE SCREWDRIVER 1.5/2.0mm
|
Facility
|
IP
|
$2,757.00
|
|
| Hospital Charge Code |
270656594
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$413.55 |
| Max. Negotiated Rate |
$413.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$413.55
|
|
|
BLADE SCREWDRIVER 1.5/2.0mm
|
Facility
|
OP
|
$2,757.00
|
|
| Hospital Charge Code |
270656594
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.44 |
| Max. Negotiated Rate |
$1,378.50 |
| Rate for Payer: Aetna Commercial |
$1,047.66
|
| Rate for Payer: Aetna Medicare Advantage |
$827.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$703.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$703.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$703.03
|
| Rate for Payer: Cigna Commercial |
$1,378.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$827.10
|
| Rate for Payer: Oxford Commercial |
$551.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$413.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$551.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$66.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$73.06
|
|
|
BLADES DISPOSABLE STERNUM SAW
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
270657616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$76.00
|
| Rate for Payer: Aetna Medicare Advantage |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.00
|
| Rate for Payer: Cigna Commercial |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.00
|
| Rate for Payer: Oxford Commercial |
$40.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.30
|
|
|
BLADES DISPOSABLE STERNUM SAW
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270657616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
BLADE SET E SHAPER
|
Facility
|
OP
|
$3,750.00
|
|
| Hospital Charge Code |
270670839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.38 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,425.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$956.25
|
| Rate for Payer: Cigna Commercial |
$1,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,125.00
|
| Rate for Payer: Oxford Commercial |
$750.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$750.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99.38
|
|
|
BLADE SET E SHAPER
|
Facility
|
IP
|
$3,750.00
|
|
| Hospital Charge Code |
270670839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$562.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
BLADE SHARP HOOK 10CM
|
Facility
|
IP
|
$4,600.00
|
|
| Hospital Charge Code |
270610060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.00 |
| Max. Negotiated Rate |
$690.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$690.00
|
|
|
BLADE SHARP HOOK 10CM
|
Facility
|
OP
|
$4,600.00
|
|
| Hospital Charge Code |
270610060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.86 |
| Max. Negotiated Rate |
$2,300.00 |
| Rate for Payer: Aetna Commercial |
$1,748.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,380.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,173.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,173.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,173.00
|
| Rate for Payer: Cigna Commercial |
$2,300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,380.00
|
| Rate for Payer: Oxford Commercial |
$920.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$690.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$920.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$110.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$121.90
|
|
|
BLADE SHAVER AGG 3.5 275534000
|
Facility
|
OP
|
$313.25
|
|
| Hospital Charge Code |
270633197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$156.62 |
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna Medicare Advantage |
$93.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.88
|
| Rate for Payer: Cigna Commercial |
$156.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.97
|
| Rate for Payer: Oxford Commercial |
$62.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.30
|
|
|
BLADE SHAVER AGG 3.5 275534000
|
Facility
|
IP
|
$313.25
|
|
| Hospital Charge Code |
270633197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$46.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.99
|
|
|
BLADE SHAVER FULL RAD 2MMX7CM
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270695939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|