|
CUP ZIM BIPOL 48MM 5000-48-28
|
Facility
|
OP
|
$3,028.85
|
|
| Hospital Charge Code |
270614880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$454.33 |
| Max. Negotiated Rate |
$1,514.42 |
| Rate for Payer: Aetna Commercial |
$908.65
|
| Rate for Payer: Aetna Medicare Advantage |
$908.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$772.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$772.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$605.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$772.36
|
| Rate for Payer: Cigna Commercial |
$1,514.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$732.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$454.33
|
|
|
CUP ZIM BIPOL 48MM 5000-48-28
|
Facility
|
IP
|
$3,028.85
|
|
| Hospital Charge Code |
270614880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$454.33 |
| Max. Negotiated Rate |
$732.98 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$605.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$732.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$454.33
|
|
|
CUP ZIM BIPOL 49MM 5000-49-28
|
Facility
|
OP
|
$3,208.00
|
|
| Hospital Charge Code |
270607715
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$481.20 |
| Max. Negotiated Rate |
$1,604.00 |
| Rate for Payer: Aetna Commercial |
$962.40
|
| Rate for Payer: Aetna Medicare Advantage |
$962.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$818.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$818.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$641.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$818.04
|
| Rate for Payer: Cigna Commercial |
$1,604.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$776.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$481.20
|
|
|
CUP ZIM BIPOL 49MM 5000-49-28
|
Facility
|
IP
|
$3,208.00
|
|
| Hospital Charge Code |
270607715
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$481.20 |
| Max. Negotiated Rate |
$776.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$641.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$776.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$481.20
|
|
|
CUP ZIM BIPOL 50MM 5000-50-28
|
Facility
|
IP
|
$3,033.65
|
|
| Hospital Charge Code |
270616092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$455.05 |
| Max. Negotiated Rate |
$734.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$606.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$734.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$455.05
|
|
|
CUP ZIM BIPOL 50MM 5000-50-28
|
Facility
|
OP
|
$3,033.65
|
|
| Hospital Charge Code |
270616092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$455.05 |
| Max. Negotiated Rate |
$1,516.83 |
| Rate for Payer: Aetna Commercial |
$910.10
|
| Rate for Payer: Aetna Medicare Advantage |
$910.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$773.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$773.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$606.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$773.58
|
| Rate for Payer: Cigna Commercial |
$1,516.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$734.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$455.05
|
|
|
CUP ZIM BIPOL 51MM 5000-51-28
|
Facility
|
OP
|
$3,208.00
|
|
| Hospital Charge Code |
270606559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$481.20 |
| Max. Negotiated Rate |
$1,604.00 |
| Rate for Payer: Aetna Commercial |
$962.40
|
| Rate for Payer: Aetna Medicare Advantage |
$962.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$818.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$818.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$641.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$818.04
|
| Rate for Payer: Cigna Commercial |
$1,604.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$776.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$481.20
|
|
|
CUP ZIM BIPOL 51MM 5000-51-28
|
Facility
|
IP
|
$3,208.00
|
|
| Hospital Charge Code |
270606559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$481.20 |
| Max. Negotiated Rate |
$776.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$641.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$776.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$481.20
|
|
|
CUP ZIM BIPOL 53MM 5000-53-28
|
Facility
|
OP
|
$3,205.65
|
|
| Hospital Charge Code |
270601273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$480.85 |
| Max. Negotiated Rate |
$1,602.83 |
| Rate for Payer: Aetna Commercial |
$961.70
|
| Rate for Payer: Aetna Medicare Advantage |
$961.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$817.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$817.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$641.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$817.44
|
| Rate for Payer: Cigna Commercial |
$1,602.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$775.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$480.85
|
|
|
CUP ZIM BIPOL 53MM 5000-53-28
|
Facility
|
IP
|
$3,205.65
|
|
| Hospital Charge Code |
270601273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$480.85 |
| Max. Negotiated Rate |
$775.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$641.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$775.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$480.85
|
|
|
CUP ZIM BIPOL 55MM 5000-55-28
|
Facility
|
IP
|
$3,121.65
|
|
| Hospital Charge Code |
270619567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$755.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$624.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$755.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.25
|
|
|
CUP ZIM BIPOL 55MM 5000-55-28
|
Facility
|
OP
|
$3,121.65
|
|
| Hospital Charge Code |
270619567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$1,560.83 |
| Rate for Payer: Aetna Commercial |
$936.50
|
| Rate for Payer: Aetna Medicare Advantage |
$936.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$796.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$796.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$624.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$796.02
|
| Rate for Payer: Cigna Commercial |
$1,560.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$755.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.25
|
|
|
CUP ZIM TRIL 58 62005820
|
Facility
|
OP
|
$6,537.65
|
|
| Hospital Charge Code |
270606807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.65 |
| Max. Negotiated Rate |
$3,268.82 |
| Rate for Payer: Aetna Commercial |
$1,961.30
|
| Rate for Payer: Aetna Medicare Advantage |
$1,961.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,667.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,667.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,307.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,667.10
|
| Rate for Payer: Cigna Commercial |
$3,268.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,582.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$980.65
|
|
|
CUP ZIM TRIL 58 62005820
|
Facility
|
IP
|
$6,537.65
|
|
| Hospital Charge Code |
270606807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.65 |
| Max. Negotiated Rate |
$1,582.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,307.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,582.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$980.65
|
|
|
CURCIUT VENT M2290 SINGLE HEAT
|
Facility
|
IP
|
$1,227.60
|
|
| Hospital Charge Code |
270651836
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$184.14 |
| Max. Negotiated Rate |
$184.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$184.14
|
|
|
CURCIUT VENT M2290 SINGLE HEAT
|
Facility
|
OP
|
$1,227.60
|
|
| Hospital Charge Code |
270651836
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$159.59 |
| Max. Negotiated Rate |
$613.80 |
| Rate for Payer: Aetna Commercial |
$368.28
|
| Rate for Payer: Aetna Medicare Advantage |
$368.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$313.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$313.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$313.04
|
| Rate for Payer: Cigna Commercial |
$613.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.59
|
| Rate for Payer: Oxford Commercial |
$613.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$184.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$613.80
|
|
|
CURE ACP DRILL S1-700-430-12
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
270702196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
CURE ACP DRILL S1-700-430-12
|
Facility
|
IP
|
$750.00
|
|
| Hospital Charge Code |
270702196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
CURETTE BMT REVERSE 5MM 423859
|
Facility
|
OP
|
$1,556.85
|
|
| Hospital Charge Code |
270615804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.39 |
| Max. Negotiated Rate |
$778.42 |
| Rate for Payer: Aetna Commercial |
$467.06
|
| Rate for Payer: Aetna Medicare Advantage |
$467.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$397.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$397.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$397.00
|
| Rate for Payer: Cigna Commercial |
$778.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$202.39
|
| Rate for Payer: Oxford Commercial |
$778.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$778.42
|
|
|
CURETTE BMT REVERSE 5MM 423859
|
Facility
|
IP
|
$1,556.85
|
|
| Hospital Charge Code |
270615804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.53 |
| Max. Negotiated Rate |
$233.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.53
|
|
|
CURETTE LATITUDE 6mm
|
Facility
|
OP
|
$967.25
|
|
| Hospital Charge Code |
270636395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.74 |
| Max. Negotiated Rate |
$483.62 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare Advantage |
$290.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$246.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$246.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$246.65
|
| Rate for Payer: Cigna Commercial |
$483.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.74
|
| Rate for Payer: Oxford Commercial |
$483.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$483.62
|
|
|
CURETTE LATITUDE 6mm
|
Facility
|
IP
|
$967.25
|
|
| Hospital Charge Code |
270636395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.09 |
| Max. Negotiated Rate |
$145.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.09
|
|
|
CURETTE VAC 7MM CRV 40789-307
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270600251
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.30
|
| Rate for Payer: Oxford Commercial |
$12.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.70
|
|
|
CURETTE VAC 7MM CRV 40789-307
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270600251
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VAC BUSSE ******
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
1607324
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.06
|
| Rate for Payer: Cigna Commercial |
$6.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.80
|
|