|
DRILL BIT LOCKNG SHORT 4.3X216
|
Facility
|
OP
|
$1,849.00
|
|
| Hospital Charge Code |
270693030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$240.37 |
| Max. Negotiated Rate |
$924.50 |
| Rate for Payer: Aetna Commercial |
$554.70
|
| Rate for Payer: Aetna Medicare Advantage |
$554.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.50
|
| Rate for Payer: Cigna Commercial |
$924.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.37
|
| Rate for Payer: Oxford Commercial |
$924.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$924.50
|
|
|
DRILL BIT LOCK SHORT 3.1X216MM
|
Facility
|
IP
|
$1,848.40
|
|
| Hospital Charge Code |
270692185
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.26 |
| Max. Negotiated Rate |
$277.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.26
|
|
|
DRILL BIT LOCK SHORT 3.1X216MM
|
Facility
|
OP
|
$1,848.40
|
|
| Hospital Charge Code |
270692185
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$240.29 |
| Max. Negotiated Rate |
$924.20 |
| Rate for Payer: Aetna Commercial |
$554.52
|
| Rate for Payer: Aetna Medicare Advantage |
$554.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.34
|
| Rate for Payer: Cigna Commercial |
$924.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.29
|
| Rate for Payer: Oxford Commercial |
$924.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$924.20
|
|
|
DRILL BIT M 1.0MM
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$114.45
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.59
|
| Rate for Payer: Oxford Commercial |
$190.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.75
|
|
|
DRILL BIT M 1.0MM
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
DRILL BIT M 1.1MM
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
DRILL BIT M 1.1MM
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$114.45
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.59
|
| Rate for Payer: Oxford Commercial |
$190.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.75
|
|
|
DRILL BIT M 1.3MM
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674524
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
DRILL BIT M 1.3MM
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674524
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$114.45
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.59
|
| Rate for Payer: Oxford Commercial |
$190.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.75
|
|
|
DRILL BIT M 1.5MM
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$114.45
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.59
|
| Rate for Payer: Oxford Commercial |
$190.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.75
|
|
|
DRILL BIT M 1.5MM
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
DRILL BIT M 2.0MM
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674528
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$114.45
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.59
|
| Rate for Payer: Oxford Commercial |
$190.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.75
|
|
|
DRILL BIT M 2.0MM
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674528
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
DRILL BIT M 2.5MM
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674530
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
DRILL BIT M 2.5MM
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674530
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.59 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$114.45
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.59
|
| Rate for Payer: Oxford Commercial |
$190.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.75
|
|
|
DRILL BIT MAXTORQUE 2.7MM
|
Facility
|
OP
|
$820.00
|
|
| Hospital Charge Code |
270700660
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.60 |
| Max. Negotiated Rate |
$410.00 |
| Rate for Payer: Aetna Commercial |
$246.00
|
| Rate for Payer: Aetna Medicare Advantage |
$246.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$209.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$209.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$209.10
|
| Rate for Payer: Cigna Commercial |
$410.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.60
|
| Rate for Payer: Oxford Commercial |
$410.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$410.00
|
|
|
DRILL BIT MAXTORQUE 2.7MM
|
Facility
|
IP
|
$820.00
|
|
| Hospital Charge Code |
270700660
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.00 |
| Max. Negotiated Rate |
$123.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.00
|
|
|
DRILL BIT MEMOFIX 2.7MM
|
Facility
|
OP
|
$1,738.00
|
|
| Hospital Charge Code |
270674854
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.94 |
| Max. Negotiated Rate |
$869.00 |
| Rate for Payer: Aetna Commercial |
$521.40
|
| Rate for Payer: Aetna Medicare Advantage |
$521.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$443.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$443.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$443.19
|
| Rate for Payer: Cigna Commercial |
$869.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$225.94
|
| Rate for Payer: Oxford Commercial |
$869.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$260.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$869.00
|
|
|
DRILL BIT MEMOFIX 2.7MM
|
Facility
|
IP
|
$1,738.00
|
|
| Hospital Charge Code |
270674854
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$260.70 |
| Max. Negotiated Rate |
$260.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$260.70
|
|
|
DRILL BIT MINI AO 1.2 MM CALIB
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270689943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$104.00
|
| Rate for Payer: Oxford Commercial |
$400.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$400.00
|
|
|
DRILL BIT MINI AO 1.2 MM CALIB
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270689943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
DRILL BIT MINI AO 1.4MM
|
Facility
|
OP
|
$867.75
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270699857
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.81 |
| Max. Negotiated Rate |
$433.88 |
| Rate for Payer: Aetna Commercial |
$260.32
|
| Rate for Payer: Aetna Medicare Advantage |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.28
|
| Rate for Payer: Cigna Commercial |
$433.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.81
|
| Rate for Payer: Oxford Commercial |
$433.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$433.88
|
|
|
DRILL BIT MINI AO 1.4MM
|
Facility
|
IP
|
$867.75
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270699857
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.16 |
| Max. Negotiated Rate |
$130.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.16
|
|
|
DRILL BIT MINI AO 1.6MM
|
Facility
|
IP
|
$867.75
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270699864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.16 |
| Max. Negotiated Rate |
$130.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.16
|
|
|
DRILL BIT MINI AO 1.6MM
|
Facility
|
OP
|
$867.75
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270699864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.81 |
| Max. Negotiated Rate |
$433.88 |
| Rate for Payer: Aetna Commercial |
$260.32
|
| Rate for Payer: Aetna Medicare Advantage |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.28
|
| Rate for Payer: Cigna Commercial |
$433.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.81
|
| Rate for Payer: Oxford Commercial |
$433.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$433.88
|
|