|
CUTTER DISPOSIBLE
|
Facility
|
OP
|
$427.60
|
|
| Hospital Charge Code |
270659979
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$213.80 |
| Rate for Payer: Aetna Commercial |
$128.28
|
| Rate for Payer: Aetna Medicare Advantage |
$128.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$109.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$109.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$109.04
|
| Rate for Payer: Cigna Commercial |
$213.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.59
|
| Rate for Payer: Oxford Commercial |
$213.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$213.80
|
|
|
CUTTER DRIVER DIRECT GEN5
|
Facility
|
OP
|
$0.01
|
|
| Hospital Charge Code |
270649461S
|
|
Hospital Revenue Code
|
272
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$0.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.01
|
|
|
CUTTER DRIVER DIRECT GEN5
|
Facility
|
IP
|
$0.01
|
|
| Hospital Charge Code |
270649461S
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
CUTTER ECHELON 60 LINEAR
|
Facility
|
OP
|
$229.64
|
|
| Hospital Charge Code |
270608732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.85 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$68.89
|
| Rate for Payer: Aetna Medicare Advantage |
$68.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.56
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.85
|
| Rate for Payer: Oxford Commercial |
$114.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.82
|
|
|
CUTTER ECHELON 60 LINEAR
|
Facility
|
IP
|
$229.64
|
|
| Hospital Charge Code |
270608732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.45 |
| Max. Negotiated Rate |
$34.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.45
|
|
|
CUTTER ECHELON LINEAR 45MM
|
Facility
|
IP
|
$2,026.95
|
|
| Hospital Charge Code |
270670865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.04 |
| Max. Negotiated Rate |
$304.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$304.04
|
|
|
CUTTER ECHELON LINEAR 45MM
|
Facility
|
OP
|
$2,026.95
|
|
| Hospital Charge Code |
270670865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.50 |
| Max. Negotiated Rate |
$1,013.48 |
| Rate for Payer: Aetna Commercial |
$608.09
|
| Rate for Payer: Aetna Medicare Advantage |
$608.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.87
|
| Rate for Payer: Cigna Commercial |
$1,013.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$263.50
|
| Rate for Payer: Oxford Commercial |
$1,013.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$304.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,013.48
|
|
|
CUTTER ENDO 35MM
|
Facility
|
IP
|
$1,419.98
|
|
| Hospital Charge Code |
270658493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$213.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$213.00
|
|
|
CUTTER ENDO 35MM
|
Facility
|
OP
|
$1,419.98
|
|
| Hospital Charge Code |
270658493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.60 |
| Max. Negotiated Rate |
$709.99 |
| Rate for Payer: Aetna Commercial |
$425.99
|
| Rate for Payer: Aetna Medicare Advantage |
$425.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$362.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$362.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$362.09
|
| Rate for Payer: Cigna Commercial |
$709.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$184.60
|
| Rate for Payer: Oxford Commercial |
$709.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$213.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$709.99
|
|
|
CUTTER ENDO PRELOADED WHT 35MM
|
Facility
|
IP
|
$115.00
|
|
| Hospital Charge Code |
270656581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
CUTTER ENDO PRELOADED WHT 35MM
|
Facility
|
OP
|
$115.00
|
|
| Hospital Charge Code |
270656581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$34.50
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Oxford Commercial |
$57.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$57.50
|
|
|
CUTTER ENDOSCOPIC ECHELON
|
Facility
|
OP
|
$1,925.08
|
|
| Hospital Charge Code |
270662483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.26 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$577.52
|
| Rate for Payer: Aetna Medicare Advantage |
$577.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$490.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$490.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$490.90
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.26
|
| Rate for Payer: Oxford Commercial |
$962.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$962.54
|
|
|
CUTTER ENDOSCOPIC ECHELON
|
Facility
|
IP
|
$1,925.08
|
|
| Hospital Charge Code |
270662483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$288.76 |
| Max. Negotiated Rate |
$288.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.76
|
|
|
CUTTER ETH ARTIC ENDO 45 ATB45
|
Facility
|
OP
|
$1,566.65
|
|
| Hospital Charge Code |
270625728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$203.66 |
| Max. Negotiated Rate |
$783.33 |
| Rate for Payer: Aetna Commercial |
$470.00
|
| Rate for Payer: Aetna Medicare Advantage |
$470.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$399.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$399.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$399.50
|
| Rate for Payer: Cigna Commercial |
$783.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$203.66
|
| Rate for Payer: Oxford Commercial |
$783.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$235.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$783.33
|
|
|
CUTTER ETH ARTIC ENDO 45 ATB45
|
Facility
|
IP
|
$1,566.65
|
|
| Hospital Charge Code |
270625728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$235.00 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$235.00
|
|
|
CUTTER ETH ARTIC ENDO 45 TR45W
|
Facility
|
OP
|
$1,172.58
|
|
| Hospital Charge Code |
270625420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.44 |
| Max. Negotiated Rate |
$586.29 |
| Rate for Payer: Aetna Commercial |
$351.77
|
| Rate for Payer: Aetna Medicare Advantage |
$351.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$299.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$299.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$299.01
|
| Rate for Payer: Cigna Commercial |
$586.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.44
|
| Rate for Payer: Oxford Commercial |
$586.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$586.29
|
|
|
CUTTER ETH ARTIC ENDO 45 TR45W
|
Facility
|
IP
|
$1,172.58
|
|
| Hospital Charge Code |
270625420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.89 |
| Max. Negotiated Rate |
$175.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.89
|
|
|
CUTTER FULL RADIUS 3.5MM
|
Facility
|
OP
|
$1,283.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270658028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.56 |
| Max. Negotiated Rate |
$641.88 |
| Rate for Payer: Aetna Commercial |
$385.12
|
| Rate for Payer: Aetna Medicare Advantage |
$385.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$327.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$327.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$256.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$327.36
|
| Rate for Payer: Cigna Commercial |
$641.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$310.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$192.56
|
|
|
CUTTER FULL RADIUS 3.5MM
|
Facility
|
IP
|
$1,283.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270658028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.56 |
| Max. Negotiated Rate |
$310.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$256.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$310.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$192.56
|
|
|
CUTTER FULL RADIUS 3.5 SMJOINT
|
Facility
|
OP
|
$166.67
|
|
| Hospital Charge Code |
270657597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.67 |
| Max. Negotiated Rate |
$83.33 |
| Rate for Payer: Aetna Commercial |
$50.00
|
| Rate for Payer: Aetna Medicare Advantage |
$50.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.50
|
| Rate for Payer: Cigna Commercial |
$83.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.67
|
| Rate for Payer: Oxford Commercial |
$83.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$83.33
|
|
|
CUTTER FULL RADIUS 3.5 SMJOINT
|
Facility
|
IP
|
$166.67
|
|
| Hospital Charge Code |
270657597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.00
|
|
|
CUTTER FULL RAD SM JOINT 2.5MM
|
Facility
|
IP
|
$238.76
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270658007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$57.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.81
|
|
|
CUTTER FULL RAD SM JOINT 2.5MM
|
Facility
|
OP
|
$238.76
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270658007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$119.38 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare Advantage |
$71.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.88
|
| Rate for Payer: Cigna Commercial |
$119.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.81
|
|
|
CUTTER GATOR SHAVER 4.2MM
|
Facility
|
IP
|
$236.90
|
|
| Hospital Charge Code |
270677535
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.53 |
| Max. Negotiated Rate |
$35.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.53
|
|
|
CUTTER GATOR SHAVER 4.2MM
|
Facility
|
OP
|
$236.90
|
|
| Hospital Charge Code |
270677535
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$118.45 |
| Rate for Payer: Aetna Commercial |
$71.07
|
| Rate for Payer: Aetna Medicare Advantage |
$71.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.41
|
| Rate for Payer: Cigna Commercial |
$118.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.80
|
| Rate for Payer: Oxford Commercial |
$118.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$118.45
|
|