|
BURR PEAR LGTH 23x5MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.45
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.11
|
|
|
BURR PEAR LGTH 24x6MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.45
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.11
|
|
|
BURR PEAR LGTH 24x6MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 28x5MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674603
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.45
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.11
|
|
|
BURR PEAR LGTH 28x5MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674603
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 28x6MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 28x6MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.45
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.11
|
|
|
BURR PEAR LGTH 45x5MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674604
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.45
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.11
|
|
|
BURR PEAR LGTH 45x5MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674604
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 45x6MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674607
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 45x6MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674607
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.45
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.11
|
|
|
BURR PEAR M 4MM HD LGTH 6.9MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674624
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR M 4MM HD LGTH 6.9MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674624
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.70
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.72
|
|
|
BURR PEAR M 5MM HD LGTH 8.3MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR M 5MM HD LGTH 8.3MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.70
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.72
|
|
|
BURR PEAR M 6MM HD LGTH 9.7MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR M 6MM HD LGTH 9.7MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.70
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.72
|
|
|
BURR PEAR S 4MM HD LGTH 6.9MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.70
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.72
|
|
|
BURR PEAR S 4MM HD LGTH 6.9MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR S 5MM HD LGTH 8.3MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674452
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.70
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.72
|
|
|
BURR PEAR S 5MM HD LGTH 8.3MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674452
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR S 6MM HD LGTH 9.7MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.70
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.72
|
|
|
BURR PEAR S 6MM HD LGTH 9.7MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PIN L 3MM HD LGTH 19.5MM
|
Facility
|
IP
|
$430.50
|
|
| Hospital Charge Code |
270674637
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.58 |
| Max. Negotiated Rate |
$64.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.58
|
|
|
BURR PIN L 3MM HD LGTH 19.5MM
|
Facility
|
OP
|
$430.50
|
|
| Hospital Charge Code |
270674637
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$215.25 |
| Rate for Payer: Aetna Commercial |
$163.59
|
| Rate for Payer: Aetna Medicare Advantage |
$129.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$109.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$109.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$109.78
|
| Rate for Payer: Cigna Commercial |
$215.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.15
|
| Rate for Payer: Oxford Commercial |
$86.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$86.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.41
|
|