|
CUTTER RESECTOR 5.5mm
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270612085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
CUTTER RESECTOR 5mm
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
270601428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$60.00
|
| 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 |
$26.00
|
| Rate for Payer: Oxford Commercial |
$100.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$100.00
|
|
|
CUTTER RESECTOR 5mm
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270601428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
CUTTER RESECTOR BONE PLUG 4mm
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270641987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
CUTTER RESECTOR BONE PLUG 4mm
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270641987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.70
|
| Rate for Payer: Oxford Commercial |
$95.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.00
|
|
|
CUTTER SLOTTED WHISKER 4.0MM
|
Facility
|
OP
|
$1,691.25
|
|
| Hospital Charge Code |
270658039
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.86 |
| Max. Negotiated Rate |
$845.62 |
| Rate for Payer: Aetna Commercial |
$507.38
|
| Rate for Payer: Aetna Medicare Advantage |
$507.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$431.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$431.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$431.27
|
| Rate for Payer: Cigna Commercial |
$845.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.86
|
| Rate for Payer: Oxford Commercial |
$845.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$253.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$845.62
|
|
|
CUTTER SLOTTED WHISKER 4.0MM
|
Facility
|
IP
|
$1,691.25
|
|
| Hospital Charge Code |
270658039
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.69 |
| Max. Negotiated Rate |
$253.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$253.69
|
|
|
CUTTER SLOTTED WHISKER 4mm
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270619067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.70
|
| Rate for Payer: Oxford Commercial |
$95.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.00
|
|
|
CUTTER SLOTTED WHISKER 4mm
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270619067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
CUTTER STRY AGGRES *****
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
1606490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$48.00
|
| Rate for Payer: Aetna Medicare Advantage |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.80
|
| Rate for Payer: Cigna Commercial |
$80.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.80
|
| Rate for Payer: Oxford Commercial |
$80.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.00
|
|
|
CUTTER STRY AGGRES *****
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
1606490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.00
|
|
|
CUTTER STRY AGGRES ********
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
1606441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.00
|
|
|
CUTTER STRY AGGRES ********
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
1606441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$48.00
|
| Rate for Payer: Aetna Medicare Advantage |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.80
|
| Rate for Payer: Cigna Commercial |
$80.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.80
|
| Rate for Payer: Oxford Commercial |
$80.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.00
|
|
|
CUTTER STRY AGGRES 2.5MM
|
Facility
|
OP
|
$264.16
|
|
| Hospital Charge Code |
270601425
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.34 |
| Max. Negotiated Rate |
$132.08 |
| Rate for Payer: Aetna Commercial |
$79.25
|
| Rate for Payer: Aetna Medicare Advantage |
$79.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.36
|
| Rate for Payer: Cigna Commercial |
$132.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.34
|
| Rate for Payer: Oxford Commercial |
$132.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.08
|
|
|
CUTTER STRY AGGRES 2.5MM
|
Facility
|
IP
|
$264.16
|
|
| Hospital Charge Code |
270601425
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$39.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.62
|
|
|
CUTTER STRY AGGRES 3.5MM
|
Facility
|
IP
|
$811.25
|
|
| Hospital Charge Code |
270601430
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.69 |
| Max. Negotiated Rate |
$121.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.69
|
|
|
CUTTER STRY AGGRES 3.5MM
|
Facility
|
OP
|
$811.25
|
|
| Hospital Charge Code |
270601430
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.46 |
| Max. Negotiated Rate |
$405.62 |
| Rate for Payer: Aetna Commercial |
$243.38
|
| Rate for Payer: Aetna Medicare Advantage |
$243.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$206.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$206.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$206.87
|
| Rate for Payer: Cigna Commercial |
$405.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.46
|
| Rate for Payer: Oxford Commercial |
$405.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$405.62
|
|
|
CUTTER STRY AGGRES 4.0MM
|
Facility
|
OP
|
$332.70
|
|
| Hospital Charge Code |
270601416
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.25 |
| Max. Negotiated Rate |
$166.35 |
| Rate for Payer: Aetna Commercial |
$99.81
|
| Rate for Payer: Aetna Medicare Advantage |
$99.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.84
|
| Rate for Payer: Cigna Commercial |
$166.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.25
|
| Rate for Payer: Oxford Commercial |
$166.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$166.35
|
|
|
CUTTER STRY AGGRES 4.0MM
|
Facility
|
IP
|
$332.70
|
|
| Hospital Charge Code |
270601416
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.91 |
| Max. Negotiated Rate |
$49.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.91
|
|
|
CUTTER STRY AGGRES ANG *****
|
Facility
|
IP
|
$177.00
|
|
| Hospital Charge Code |
1606482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.55 |
| Max. Negotiated Rate |
$26.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.55
|
|
|
CUTTER STRY AGGRES ANG *****
|
Facility
|
OP
|
$177.00
|
|
| Hospital Charge Code |
1606482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.01 |
| Max. Negotiated Rate |
$88.50 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: Aetna Medicare Advantage |
$53.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.13
|
| Rate for Payer: Cigna Commercial |
$88.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.01
|
| Rate for Payer: Oxford Commercial |
$88.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$88.50
|
|
|
CUTTER STRY AGGRES ANG 4.0MM
|
Facility
|
OP
|
$872.00
|
|
| Hospital Charge Code |
270601418
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.36 |
| Max. Negotiated Rate |
$436.00 |
| Rate for Payer: Aetna Commercial |
$261.60
|
| Rate for Payer: Aetna Medicare Advantage |
$261.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$222.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$222.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$222.36
|
| Rate for Payer: Cigna Commercial |
$436.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.36
|
| Rate for Payer: Oxford Commercial |
$436.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$436.00
|
|
|
CUTTER STRY AGGRES ANG 4.0MM
|
Facility
|
IP
|
$872.00
|
|
| Hospital Charge Code |
270601418
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.80 |
| Max. Negotiated Rate |
$130.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.80
|
|
|
CUTTER STRY AGGRES MENIS ****
|
Facility
|
OP
|
$284.00
|
|
| Hospital Charge Code |
1606532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.92 |
| Max. Negotiated Rate |
$142.00 |
| Rate for Payer: Aetna Commercial |
$85.20
|
| Rate for Payer: Aetna Medicare Advantage |
$85.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.42
|
| Rate for Payer: Cigna Commercial |
$142.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.92
|
| Rate for Payer: Oxford Commercial |
$142.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$142.00
|
|
|
CUTTER STRY AGGRES MENIS ****
|
Facility
|
IP
|
$284.00
|
|
| Hospital Charge Code |
1606532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$42.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.60
|
|