|
DRILL HIGH SPEED 2.5MM
|
Facility
|
IP
|
$989.85
|
|
| Hospital Charge Code |
270681646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$148.48 |
| Max. Negotiated Rate |
$148.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$148.48
|
|
|
DRILL HIGH SPEED 2.5MM
|
Facility
|
OP
|
$989.85
|
|
| Hospital Charge Code |
270681646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$128.68 |
| Max. Negotiated Rate |
$494.93 |
| Rate for Payer: Aetna Commercial |
$296.95
|
| Rate for Payer: Aetna Medicare Advantage |
$296.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.41
|
| Rate for Payer: Cigna Commercial |
$494.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$128.68
|
| Rate for Payer: Oxford Commercial |
$494.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$148.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$494.93
|
|
|
DRILL ,HIP PL, SHORT HB,2.9MM
|
Facility
|
IP
|
$775.00
|
|
| Hospital Charge Code |
270681508
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.25 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.25
|
|
|
DRILL ,HIP PL, SHORT HB,2.9MM
|
Facility
|
OP
|
$775.00
|
|
| Hospital Charge Code |
270681508
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$387.50 |
| Rate for Payer: Aetna Commercial |
$232.50
|
| Rate for Payer: Aetna Medicare Advantage |
$232.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$197.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$197.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$197.62
|
| Rate for Payer: Cigna Commercial |
$387.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.75
|
| Rate for Payer: Oxford Commercial |
$387.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$387.50
|
|
|
DRILL HOLE IMPLT VENTRIC DEVIC
|
Facility
|
IP
|
$61,616.39
|
|
|
Service Code
|
HCPCS 61107
|
| Hospital Charge Code |
411061107
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,242.46 |
| Max. Negotiated Rate |
$9,242.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,242.46
|
|
|
DRILL HOLE IMPLT VENTRIC DEVIC
|
Facility
|
OP
|
$61,616.39
|
|
|
Service Code
|
HCPCS 61107
|
| Hospital Charge Code |
411061107
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$311.55 |
| Max. Negotiated Rate |
$18,484.92 |
| Rate for Payer: Aetna Commercial |
$18,484.92
|
| Rate for Payer: Aetna Medicare Advantage |
$18,484.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,712.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,712.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,712.18
|
| Rate for Payer: Cigna Commercial |
$311.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,010.13
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,242.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
DRILL HOLE WITNESS
|
Facility
|
OP
|
$1,090.00
|
|
| Hospital Charge Code |
270671066
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$141.70 |
| Max. Negotiated Rate |
$545.00 |
| Rate for Payer: Aetna Commercial |
$327.00
|
| Rate for Payer: Aetna Medicare Advantage |
$327.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$277.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$277.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$277.95
|
| Rate for Payer: Cigna Commercial |
$545.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$141.70
|
| Rate for Payer: Oxford Commercial |
$545.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$545.00
|
|
|
DRILL HOLE WITNESS
|
Facility
|
IP
|
$1,090.00
|
|
| Hospital Charge Code |
270671066
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.50 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.50
|
|
|
DRILL ICONIX 2.3MM DISP
|
Facility
|
OP
|
$1,005.70
|
|
| Hospital Charge Code |
270676525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.74 |
| Max. Negotiated Rate |
$502.85 |
| Rate for Payer: Aetna Commercial |
$301.71
|
| Rate for Payer: Aetna Medicare Advantage |
$301.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$256.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$256.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$256.45
|
| Rate for Payer: Cigna Commercial |
$502.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.74
|
| Rate for Payer: Oxford Commercial |
$502.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$502.85
|
|
|
DRILL ICONIX 2.3MM DISP
|
Facility
|
IP
|
$1,005.70
|
|
| Hospital Charge Code |
270676525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.85 |
| Max. Negotiated Rate |
$150.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.85
|
|
|
DRILL ICONIX DISP 1.4MM
|
Facility
|
OP
|
$1,005.70
|
|
| Hospital Charge Code |
270681343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.74 |
| Max. Negotiated Rate |
$502.85 |
| Rate for Payer: Aetna Commercial |
$301.71
|
| Rate for Payer: Aetna Medicare Advantage |
$301.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$256.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$256.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$256.45
|
| Rate for Payer: Cigna Commercial |
$502.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.74
|
| Rate for Payer: Oxford Commercial |
$502.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$502.85
|
|
|
DRILL ICONIX DISP 1.4MM
|
Facility
|
IP
|
$1,005.70
|
|
| Hospital Charge Code |
270681343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.85 |
| Max. Negotiated Rate |
$150.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.85
|
|
|
DRILLING GUIDE 3.1MM
|
Facility
|
OP
|
$552.00
|
|
| Hospital Charge Code |
270676248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.76 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare Advantage |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.76
|
| Rate for Payer: Cigna Commercial |
$276.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.76
|
| Rate for Payer: Oxford Commercial |
$276.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$276.00
|
|
|
DRILLING GUIDE 3.1MM
|
Facility
|
IP
|
$552.00
|
|
| Hospital Charge Code |
270676248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.80
|
|
|
DRILLING SCREW 4x12MM
|
Facility
|
OP
|
$2,750.00
|
|
| Hospital Charge Code |
270675883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$412.50 |
| Max. Negotiated Rate |
$1,375.00 |
| Rate for Payer: Aetna Commercial |
$825.00
|
| Rate for Payer: Aetna Medicare Advantage |
$825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$550.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$701.25
|
| Rate for Payer: Cigna Commercial |
$1,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$665.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
|
|
DRILLING SCREW 4x12MM
|
Facility
|
IP
|
$2,750.00
|
|
| Hospital Charge Code |
270675883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$412.50 |
| Max. Negotiated Rate |
$665.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$665.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
|
|
DRILL KIT BIT 2.0MM
|
Facility
|
IP
|
$1,406.60
|
|
| Hospital Charge Code |
270691075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$210.99 |
| Max. Negotiated Rate |
$210.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$210.99
|
|
|
DRILL KIT BIT 2.0MM
|
Facility
|
OP
|
$1,406.60
|
|
| Hospital Charge Code |
270691075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$182.86 |
| Max. Negotiated Rate |
$703.30 |
| Rate for Payer: Aetna Commercial |
$421.98
|
| Rate for Payer: Aetna Medicare Advantage |
$421.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$358.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$358.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$358.68
|
| Rate for Payer: Cigna Commercial |
$703.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$182.86
|
| Rate for Payer: Oxford Commercial |
$703.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$210.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$703.30
|
|
|
DRILL KIT ELITE COMPRESS 3.0MM
|
Facility
|
OP
|
$1,485.00
|
|
| Hospital Charge Code |
270681555
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.75 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$445.50
|
| Rate for Payer: Aetna Medicare Advantage |
$445.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$297.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$378.68
|
| Rate for Payer: Cigna Commercial |
$742.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$359.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.75
|
|
|
DRILL KIT ELITE COMPRESS 3.0MM
|
Facility
|
IP
|
$1,485.00
|
|
| Hospital Charge Code |
270681555
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.75 |
| Max. Negotiated Rate |
$359.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$297.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$359.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.75
|
|
|
DRILL KIT FOR CONTINUOUS COMPR
|
Facility
|
IP
|
$1,250.00
|
|
| Hospital Charge Code |
270659686
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$187.50 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.50
|
|
|
DRILL KIT FOR CONTINUOUS COMPR
|
Facility
|
OP
|
$1,250.00
|
|
| Hospital Charge Code |
270659686
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.50 |
| Max. Negotiated Rate |
$625.00 |
| Rate for Payer: Aetna Commercial |
$375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$318.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$318.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$318.75
|
| Rate for Payer: Cigna Commercial |
$625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.50
|
| Rate for Payer: Oxford Commercial |
$625.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$625.00
|
|
|
DRILL KMD 1.6MM SCREW J LTCH
|
Facility
|
IP
|
$453.65
|
|
| Hospital Charge Code |
270607680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.05 |
| Max. Negotiated Rate |
$68.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.05
|
|
|
DRILL KMD 1.6MM SCREW J LTCH
|
Facility
|
OP
|
$453.65
|
|
| Hospital Charge Code |
270607680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.97 |
| Max. Negotiated Rate |
$226.82 |
| Rate for Payer: Aetna Commercial |
$136.09
|
| Rate for Payer: Aetna Medicare Advantage |
$136.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$115.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$115.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$115.68
|
| Rate for Payer: Cigna Commercial |
$226.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.97
|
| Rate for Payer: Oxford Commercial |
$226.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$226.82
|
|
|
DRILL LONG
|
Facility
|
IP
|
$1,070.00
|
|
| Hospital Charge Code |
270677456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.50 |
| Max. Negotiated Rate |
$160.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.50
|
|