|
DRILL BIT JACOBS 2.7x85MM
|
Facility
|
IP
|
$307.45
|
|
| Hospital Charge Code |
270604451
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.12 |
| Max. Negotiated Rate |
$46.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.12
|
|
|
DRILL BIT JACOBS 2.7x85MM
|
Facility
|
OP
|
$307.45
|
|
| Hospital Charge Code |
270604451
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.97 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial |
$92.23
|
| Rate for Payer: Aetna Medicare Advantage |
$92.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.40
|
| Rate for Payer: Cigna Commercial |
$153.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.97
|
| Rate for Payer: Oxford Commercial |
$153.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.72
|
|
|
DRILL BIT JACOBS 3.5x95MM
|
Facility
|
IP
|
$316.65
|
|
| Hospital Charge Code |
270604453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.50 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.50
|
|
|
DRILL BIT JACOBS 3.5x95MM
|
Facility
|
OP
|
$316.65
|
|
| Hospital Charge Code |
270604453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.16 |
| Max. Negotiated Rate |
$158.32 |
| Rate for Payer: Aetna Commercial |
$95.00
|
| Rate for Payer: Aetna Medicare Advantage |
$95.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$80.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$80.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$80.75
|
| Rate for Payer: Cigna Commercial |
$158.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.16
|
| Rate for Payer: Oxford Commercial |
$158.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$158.32
|
|
|
DRILL BIT JACOBS GOLD 2.5x95MM
|
Facility
|
OP
|
$417.15
|
|
| Hospital Charge Code |
270604455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$208.57 |
| Rate for Payer: Aetna Commercial |
$125.14
|
| Rate for Payer: Aetna Medicare Advantage |
$125.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$106.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$106.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$106.37
|
| Rate for Payer: Cigna Commercial |
$208.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.23
|
| Rate for Payer: Oxford Commercial |
$208.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$208.57
|
|
|
DRILL BIT JACOBS GOLD 2.5x95MM
|
Facility
|
IP
|
$417.15
|
|
| Hospital Charge Code |
270604455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.57 |
| Max. Negotiated Rate |
$62.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.57
|
|
|
DRILL BIT J-LATCH 1.1x75MM
|
Facility
|
OP
|
$306.00
|
|
| Hospital Charge Code |
270675731
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Medicare Advantage |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.03
|
| Rate for Payer: Cigna Commercial |
$153.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.78
|
| Rate for Payer: Oxford Commercial |
$153.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.00
|
|
|
DRILL BIT J-LATCH 1.1x75MM
|
Facility
|
IP
|
$306.00
|
|
| Hospital Charge Code |
270675731
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.90
|
|
|
DRILL BIT J-LATCH 1.5x75MM
|
Facility
|
IP
|
$306.00
|
|
| Hospital Charge Code |
270675732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.90
|
|
|
DRILL BIT J-LATCH 1.5x75MM
|
Facility
|
OP
|
$306.00
|
|
| Hospital Charge Code |
270675732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Medicare Advantage |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.03
|
| Rate for Payer: Cigna Commercial |
$153.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.78
|
| Rate for Payer: Oxford Commercial |
$153.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.00
|
|
|
DRILL BIT J-LATCH 2.4x90MM
|
Facility
|
OP
|
$298.50
|
|
| Hospital Charge Code |
270675737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$149.25 |
| Rate for Payer: Aetna Commercial |
$89.55
|
| Rate for Payer: Aetna Medicare Advantage |
$89.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.12
|
| Rate for Payer: Cigna Commercial |
$149.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.80
|
| Rate for Payer: Oxford Commercial |
$149.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$149.25
|
|
|
DRILL BIT J-LATCH 2.4x90MM
|
Facility
|
IP
|
$298.50
|
|
| Hospital Charge Code |
270675737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.77 |
| Max. Negotiated Rate |
$44.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.77
|
|
|
DRILL BIT J-LATCH 2x75MM
|
Facility
|
IP
|
$306.00
|
|
| Hospital Charge Code |
270675733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.90
|
|
|
DRILL BIT J-LATCH 2x75MM
|
Facility
|
OP
|
$306.00
|
|
| Hospital Charge Code |
270675733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Medicare Advantage |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.03
|
| Rate for Payer: Cigna Commercial |
$153.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.78
|
| Rate for Payer: Oxford Commercial |
$153.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.00
|
|
|
DRILL BIT JUGGERKNOT SHORT2.9
|
Facility
|
OP
|
$660.00
|
|
| Hospital Charge Code |
270675057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.80 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$198.00
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.80
|
| Rate for Payer: Oxford Commercial |
$330.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$330.00
|
|
|
DRILL BIT JUGGERKNOT SHORT2.9
|
Facility
|
IP
|
$660.00
|
|
| Hospital Charge Code |
270675057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
DRILL BIT KIT 2MM X 3.2MM
|
Facility
|
IP
|
$2,070.00
|
|
| Hospital Charge Code |
270668550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$310.50 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.50
|
|
|
DRILL BIT KIT 2MM X 3.2MM
|
Facility
|
OP
|
$2,070.00
|
|
| Hospital Charge Code |
270668550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$269.10 |
| Max. Negotiated Rate |
$1,035.00 |
| Rate for Payer: Aetna Commercial |
$621.00
|
| Rate for Payer: Aetna Medicare Advantage |
$621.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$527.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$527.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$527.85
|
| Rate for Payer: Cigna Commercial |
$1,035.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$269.10
|
| Rate for Payer: Oxford Commercial |
$1,035.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,035.00
|
|
|
DRILL BIT LEG ACORN FLUTD 14CM
|
Facility
|
OP
|
$760.00
|
|
| Hospital Charge Code |
270668231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.80 |
| Max. Negotiated Rate |
$380.00 |
| Rate for Payer: Aetna Commercial |
$228.00
|
| Rate for Payer: Aetna Medicare Advantage |
$228.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$193.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$193.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$193.80
|
| Rate for Payer: Cigna Commercial |
$380.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.80
|
| Rate for Payer: Oxford Commercial |
$380.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$380.00
|
|
|
DRILL BIT LEG ACORN FLUTD 14CM
|
Facility
|
IP
|
$760.00
|
|
| Hospital Charge Code |
270668231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.00
|
|
|
DRILL BIT LEGEND TAPERED 14CM
|
Facility
|
OP
|
$817.00
|
|
| Hospital Charge Code |
270668232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.21 |
| Max. Negotiated Rate |
$408.50 |
| Rate for Payer: Aetna Commercial |
$245.10
|
| Rate for Payer: Aetna Medicare Advantage |
$245.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$208.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$208.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$208.34
|
| Rate for Payer: Cigna Commercial |
$408.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.21
|
| Rate for Payer: Oxford Commercial |
$408.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$408.50
|
|
|
DRILL BIT LEGEND TAPERED 14CM
|
Facility
|
IP
|
$817.00
|
|
| Hospital Charge Code |
270668232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$122.55 |
| Max. Negotiated Rate |
$122.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.55
|
|
|
DRILL BIT LISFANC 2.6MM
|
Facility
|
OP
|
$840.00
|
|
| Hospital Charge Code |
270686264
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Aetna Commercial |
$252.00
|
| Rate for Payer: Aetna Medicare Advantage |
$252.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$214.20
|
| Rate for Payer: Cigna Commercial |
$420.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$109.20
|
| Rate for Payer: Oxford Commercial |
$420.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$420.00
|
|
|
DRILL BIT LISFANC 2.6MM
|
Facility
|
IP
|
$840.00
|
|
| Hospital Charge Code |
270686264
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.00
|
|
|
DRILL BIT LOCKNG SHORT 4.3X216
|
Facility
|
IP
|
$1,849.00
|
|
| Hospital Charge Code |
270693030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.35 |
| Max. Negotiated Rate |
$277.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.35
|
|