|
DRILL BIT 2.5 3-FLTD 230/200MM
|
Facility
|
OP
|
$1,031.20
|
|
| Hospital Charge Code |
270677981
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$134.06 |
| Max. Negotiated Rate |
$515.60 |
| Rate for Payer: Aetna Commercial |
$309.36
|
| Rate for Payer: Aetna Medicare Advantage |
$309.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$262.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$262.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$262.96
|
| Rate for Payer: Cigna Commercial |
$515.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$134.06
|
| Rate for Payer: Oxford Commercial |
$515.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$154.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$515.60
|
|
|
DRILL BIT 2.5 3-FLTD 230/200MM
|
Facility
|
IP
|
$1,031.20
|
|
| Hospital Charge Code |
270681292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$154.68 |
| Max. Negotiated Rate |
$154.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$154.68
|
|
|
DRILL BIT 2.5 FOR PLATE
|
Facility
|
IP
|
$955.00
|
|
| Hospital Charge Code |
270667930
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.25 |
| Max. Negotiated Rate |
$143.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
|
|
DRILL BIT 2.5 FOR PLATE
|
Facility
|
OP
|
$955.00
|
|
| Hospital Charge Code |
270667930
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.15 |
| Max. Negotiated Rate |
$477.50 |
| Rate for Payer: Aetna Commercial |
$286.50
|
| Rate for Payer: Aetna Medicare Advantage |
$286.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$243.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$243.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$243.53
|
| Rate for Payer: Cigna Commercial |
$477.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.15
|
| Rate for Payer: Oxford Commercial |
$477.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$477.50
|
|
|
DRILL BIT 2.5 FOR SCREWS
|
Facility
|
IP
|
$888.30
|
|
| Hospital Charge Code |
270667929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.25 |
| Max. Negotiated Rate |
$133.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.25
|
|
|
DRILL BIT 2.5 FOR SCREWS
|
Facility
|
OP
|
$888.30
|
|
| Hospital Charge Code |
270667929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.48 |
| Max. Negotiated Rate |
$444.15 |
| Rate for Payer: Aetna Commercial |
$266.49
|
| Rate for Payer: Aetna Medicare Advantage |
$266.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.52
|
| Rate for Payer: Cigna Commercial |
$444.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.48
|
| Rate for Payer: Oxford Commercial |
$444.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$444.15
|
|
|
DRILL BIT 2.5 MM
|
Facility
|
OP
|
$340.00
|
|
| Hospital Charge Code |
270678458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.20 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$102.00
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.20
|
| Rate for Payer: Oxford Commercial |
$170.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$170.00
|
|
|
DRILL BIT 2.5 MM
|
Facility
|
IP
|
$756.70
|
|
| Hospital Charge Code |
270687283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.50 |
| Max. Negotiated Rate |
$113.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$113.50
|
|
|
DRILL BIT 2.5 MM
|
Facility
|
IP
|
$340.00
|
|
| Hospital Charge Code |
270678458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
DRILL BIT 2.5 MM
|
Facility
|
OP
|
$756.70
|
|
| Hospital Charge Code |
270687283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.37 |
| Max. Negotiated Rate |
$378.35 |
| Rate for Payer: Aetna Commercial |
$227.01
|
| Rate for Payer: Aetna Medicare Advantage |
$227.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$192.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$192.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$192.96
|
| Rate for Payer: Cigna Commercial |
$378.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.37
|
| Rate for Payer: Oxford Commercial |
$378.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$113.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$378.35
|
|
|
DRILL BIT 2.5 MM
|
Facility
|
OP
|
$300.00
|
|
| Hospital Charge Code |
270684028
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.50
|
| Rate for Payer: Cigna Commercial |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.00
|
| Rate for Payer: Oxford Commercial |
$150.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$150.00
|
|
|
DRILL BIT 2.5 MM
|
Facility
|
IP
|
$300.00
|
|
| Hospital Charge Code |
270684028
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$1,550.40
|
|
| Hospital Charge Code |
270673956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.56 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$232.56
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$2,540.65
|
|
| Hospital Charge Code |
270704456
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$381.10 |
| Max. Negotiated Rate |
$381.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$381.10
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$875.00
|
|
| Hospital Charge Code |
270664492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.75 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna Commercial |
$262.50
|
| Rate for Payer: Aetna Medicare Advantage |
$262.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.12
|
| Rate for Payer: Cigna Commercial |
$437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.75
|
| Rate for Payer: Oxford Commercial |
$437.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$437.50
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$467.50
|
|
| Hospital Charge Code |
270648250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.12 |
| Max. Negotiated Rate |
$70.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.12
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$615.00
|
|
| Hospital Charge Code |
270660762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.95 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$184.50
|
| Rate for Payer: Aetna Medicare Advantage |
$184.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$156.82
|
| Rate for Payer: Cigna Commercial |
$307.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.95
|
| Rate for Payer: Oxford Commercial |
$307.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$307.50
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$725.00
|
|
| Hospital Charge Code |
270661597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.25 |
| Max. Negotiated Rate |
$362.50 |
| Rate for Payer: Aetna Commercial |
$217.50
|
| Rate for Payer: Aetna Medicare Advantage |
$217.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$184.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$184.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$184.88
|
| Rate for Payer: Cigna Commercial |
$362.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.25
|
| Rate for Payer: Oxford Commercial |
$362.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$362.50
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$461.50
|
|
| Hospital Charge Code |
270664485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.99 |
| Max. Negotiated Rate |
$230.75 |
| Rate for Payer: Aetna Commercial |
$138.45
|
| Rate for Payer: Aetna Medicare Advantage |
$138.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$117.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$117.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$117.68
|
| Rate for Payer: Cigna Commercial |
$230.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.99
|
| Rate for Payer: Oxford Commercial |
$230.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$230.75
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$670.00
|
|
| Hospital Charge Code |
270638285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.50 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.50
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$181.95
|
|
| Hospital Charge Code |
270664049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.65 |
| Max. Negotiated Rate |
$90.97 |
| Rate for Payer: Aetna Commercial |
$54.59
|
| Rate for Payer: Aetna Medicare Advantage |
$54.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.40
|
| Rate for Payer: Cigna Commercial |
$90.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.65
|
| Rate for Payer: Oxford Commercial |
$90.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.97
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$408.00
|
|
| Hospital Charge Code |
270682615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Medicare Advantage |
$122.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104.04
|
| Rate for Payer: Cigna Commercial |
$204.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.04
|
| Rate for Payer: Oxford Commercial |
$204.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$204.00
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$615.00
|
|
| Hospital Charge Code |
270660762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$92.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.25
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$875.00
|
|
| Hospital Charge Code |
270664492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.25
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$467.50
|
|
| Hospital Charge Code |
270648250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.77 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: Aetna Commercial |
$140.25
|
| Rate for Payer: Aetna Medicare Advantage |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.21
|
| Rate for Payer: Cigna Commercial |
$233.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.77
|
| Rate for Payer: Oxford Commercial |
$233.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$233.75
|
|