|
CUTTER STRY AGGRES MENIS 4.0MM
|
Facility
|
OP
|
$447.25
|
|
| Hospital Charge Code |
270621414
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.14 |
| Max. Negotiated Rate |
$223.62 |
| Rate for Payer: Aetna Commercial |
$134.18
|
| Rate for Payer: Aetna Medicare Advantage |
$134.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$114.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$114.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$114.05
|
| Rate for Payer: Cigna Commercial |
$223.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.14
|
| Rate for Payer: Oxford Commercial |
$223.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$223.62
|
|
|
CUTTER STRY AGGRES MENIS 4.0MM
|
Facility
|
IP
|
$447.25
|
|
| Hospital Charge Code |
270621414
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$67.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.09
|
|
|
CUTTER STRY AGGRES SERRT 4.0MM
|
Facility
|
IP
|
$892.85
|
|
| Hospital Charge Code |
270601421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.93 |
| Max. Negotiated Rate |
$133.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.93
|
|
|
CUTTER STRY AGGRES SERRT 4.0MM
|
Facility
|
OP
|
$892.85
|
|
| Hospital Charge Code |
270601421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.07 |
| Max. Negotiated Rate |
$446.43 |
| Rate for Payer: Aetna Commercial |
$267.86
|
| Rate for Payer: Aetna Medicare Advantage |
$267.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$227.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$227.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$227.68
|
| Rate for Payer: Cigna Commercial |
$446.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$116.07
|
| Rate for Payer: Oxford Commercial |
$446.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$446.43
|
|
|
CUTTER STRY AGGRS 4.0 28854410
|
Facility
|
IP
|
$446.45
|
|
| Hospital Charge Code |
270619919
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.97 |
| Max. Negotiated Rate |
$66.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.97
|
|
|
CUTTER STRY AGGRS 4.0 28854410
|
Facility
|
OP
|
$446.45
|
|
| Hospital Charge Code |
270619919
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.04 |
| Max. Negotiated Rate |
$223.22 |
| Rate for Payer: Aetna Commercial |
$133.94
|
| Rate for Payer: Aetna Medicare Advantage |
$133.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$113.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$113.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$113.84
|
| Rate for Payer: Cigna Commercial |
$223.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.04
|
| Rate for Payer: Oxford Commercial |
$223.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$223.22
|
|
|
CUTTER STRY COUGAR 3.5MM
|
Facility
|
OP
|
$884.00
|
|
| Hospital Charge Code |
270601431
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.92 |
| Max. Negotiated Rate |
$442.00 |
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna Medicare Advantage |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$225.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$225.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$225.42
|
| Rate for Payer: Cigna Commercial |
$442.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.92
|
| Rate for Payer: Oxford Commercial |
$442.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$442.00
|
|
|
CUTTER STRY COUGAR 3.5MM
|
Facility
|
IP
|
$884.00
|
|
| Hospital Charge Code |
270601431
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.60
|
|
|
CUTTER STRY COUGAR 4.0MM
|
Facility
|
IP
|
$884.00
|
|
| Hospital Charge Code |
270601427
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.60
|
|
|
CUTTER STRY COUGAR 4.0MM
|
Facility
|
OP
|
$884.00
|
|
| Hospital Charge Code |
270601427
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.92 |
| Max. Negotiated Rate |
$442.00 |
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna Medicare Advantage |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$225.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$225.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$225.42
|
| Rate for Payer: Cigna Commercial |
$442.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.92
|
| Rate for Payer: Oxford Commercial |
$442.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$442.00
|
|
|
CUTTER STRY COUGAR 5.0MM
|
Facility
|
IP
|
$709.65
|
|
| Hospital Charge Code |
270601432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.45 |
| Max. Negotiated Rate |
$106.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$106.45
|
|
|
CUTTER STRY COUGAR 5.0MM
|
Facility
|
OP
|
$709.65
|
|
| Hospital Charge Code |
270601432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$354.82 |
| Rate for Payer: Aetna Commercial |
$212.90
|
| Rate for Payer: Aetna Medicare Advantage |
$212.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$180.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$180.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$180.96
|
| Rate for Payer: Cigna Commercial |
$354.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$92.25
|
| Rate for Payer: Oxford Commercial |
$354.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$106.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$354.82
|
|
|
CUTTER STRY END *****
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
1606433
|
|
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 END *****
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
1606433
|
|
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 FULL RADIUS *****
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
1606508
|
|
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 FULL RADIUS *****
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
1606391
|
|
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 FULL RADIUS *****
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
1606391
|
|
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 FULL RADIUS *****
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
1606508
|
|
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 FULL RADIUS 4.0MM
|
Facility
|
IP
|
$884.00
|
|
| Hospital Charge Code |
270604626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.60
|
|
|
CUTTER STRY FULL RADIUS 4.0MM
|
Facility
|
OP
|
$884.00
|
|
| Hospital Charge Code |
270604626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.92 |
| Max. Negotiated Rate |
$442.00 |
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna Medicare Advantage |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$225.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$225.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$225.42
|
| Rate for Payer: Cigna Commercial |
$442.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.92
|
| Rate for Payer: Oxford Commercial |
$442.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$442.00
|
|
|
CUTTER STRY JAGUAR *******
|
Facility
|
OP
|
$191.00
|
|
| Hospital Charge Code |
1606540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$95.50 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare Advantage |
$57.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.70
|
| Rate for Payer: Cigna Commercial |
$95.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.83
|
| Rate for Payer: Oxford Commercial |
$95.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.50
|
|
|
CUTTER STRY JAGUAR *******
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
1606409
|
|
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 JAGUAR *******
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
1606409
|
|
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 JAGUAR *******
|
Facility
|
IP
|
$191.00
|
|
| Hospital Charge Code |
1606540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.65 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.65
|
|
|
CUTTER STRY TOMCAT 4.0MM
|
Facility
|
OP
|
$775.25
|
|
| Hospital Charge Code |
270601424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.78 |
| Max. Negotiated Rate |
$387.62 |
| Rate for Payer: Aetna Commercial |
$232.57
|
| Rate for Payer: Aetna Medicare Advantage |
$232.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$197.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$197.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$197.69
|
| Rate for Payer: Cigna Commercial |
$387.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.78
|
| Rate for Payer: Oxford Commercial |
$387.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$387.62
|
|