|
DRILL QC GOLD 2.5x111MM STER
|
Facility
|
IP
|
$531.55
|
|
| Hospital Charge Code |
270669681
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.73 |
| Max. Negotiated Rate |
$79.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.73
|
|
|
DRILL QC TWIST 3.5X196MM STERI
|
Facility
|
OP
|
$537.00
|
|
| Hospital Charge Code |
270669682
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.81 |
| Max. Negotiated Rate |
$268.50 |
| Rate for Payer: Aetna Commercial |
$161.10
|
| Rate for Payer: Aetna Medicare Advantage |
$161.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$136.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$136.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$136.94
|
| Rate for Payer: Cigna Commercial |
$268.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.81
|
| Rate for Payer: Oxford Commercial |
$268.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$268.50
|
|
|
DRILL QC TWIST 3.5X196MM STERI
|
Facility
|
IP
|
$537.00
|
|
| Hospital Charge Code |
270669682
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.55 |
| Max. Negotiated Rate |
$80.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.55
|
|
|
DRILL QUIK CNNT 3.2LG 2410-033
|
Facility
|
OP
|
$238.45
|
|
| Hospital Charge Code |
270610452
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$119.22 |
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: Aetna Medicare Advantage |
$71.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.80
|
| Rate for Payer: Cigna Commercial |
$119.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.00
|
| Rate for Payer: Oxford Commercial |
$119.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.22
|
|
|
DRILL QUIK CNNT 3.2LG 2410-033
|
Facility
|
IP
|
$238.45
|
|
| Hospital Charge Code |
270610452
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.77 |
| Max. Negotiated Rate |
$35.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.77
|
|
|
DRILL REAMER 2.9MM/5.0MM
|
Facility
|
OP
|
$2,022.00
|
|
| Hospital Charge Code |
270662839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$262.86 |
| Max. Negotiated Rate |
$1,011.00 |
| Rate for Payer: Aetna Commercial |
$606.60
|
| Rate for Payer: Aetna Medicare Advantage |
$606.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$515.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$515.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$515.61
|
| Rate for Payer: Cigna Commercial |
$1,011.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$262.86
|
| Rate for Payer: Oxford Commercial |
$1,011.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,011.00
|
|
|
DRILL REAMER 2.9MM/5.0MM
|
Facility
|
IP
|
$2,022.00
|
|
| Hospital Charge Code |
270662839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.30 |
| Max. Negotiated Rate |
$303.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.30
|
|
|
DRILL RETRO GUIDE ASSEMBLY
|
Facility
|
OP
|
$1,040.00
|
|
| Hospital Charge Code |
270661065
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$135.20 |
| Max. Negotiated Rate |
$520.00 |
| Rate for Payer: Aetna Commercial |
$312.00
|
| Rate for Payer: Aetna Medicare Advantage |
$312.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$265.20
|
| Rate for Payer: Cigna Commercial |
$520.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.20
|
| Rate for Payer: Oxford Commercial |
$520.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$520.00
|
|
|
DRILL RETRO GUIDE ASSEMBLY
|
Facility
|
IP
|
$1,040.00
|
|
| Hospital Charge Code |
270661065
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.00
|
|
|
DRILL SHAVE 2.9MM
|
Facility
|
IP
|
$500.00
|
|
| Hospital Charge Code |
270703391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$121.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
DRILL SHAVE 2.9MM
|
Facility
|
OP
|
$500.00
|
|
| Hospital Charge Code |
270703391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna Commercial |
$150.00
|
| Rate for Payer: Aetna Medicare Advantage |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.50
|
| Rate for Payer: Cigna Commercial |
$250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
DRILL SHORT 4.0mm 71631117
|
Facility
|
OP
|
$312.50
|
|
| Hospital Charge Code |
270633367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.62 |
| Max. Negotiated Rate |
$156.25 |
| Rate for Payer: Aetna Commercial |
$93.75
|
| Rate for Payer: Aetna Medicare Advantage |
$93.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.69
|
| Rate for Payer: Cigna Commercial |
$156.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.62
|
| Rate for Payer: Oxford Commercial |
$156.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.25
|
|
|
DRILL SHORT 4.0mm 71631117
|
Facility
|
IP
|
$312.50
|
|
| Hospital Charge Code |
270633367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.88 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.88
|
|
|
DRILL SHORT 4.3
|
Facility
|
OP
|
$1,052.60
|
|
| Hospital Charge Code |
270673790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$136.84 |
| Max. Negotiated Rate |
$526.30 |
| Rate for Payer: Aetna Commercial |
$315.78
|
| Rate for Payer: Aetna Medicare Advantage |
$315.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$268.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$268.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$268.41
|
| Rate for Payer: Cigna Commercial |
$526.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$136.84
|
| Rate for Payer: Oxford Commercial |
$526.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$526.30
|
|
|
DRILL SHORT 4.3
|
Facility
|
IP
|
$1,052.60
|
|
| Hospital Charge Code |
270673790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$157.89 |
| Max. Negotiated Rate |
$157.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.89
|
|
|
DRILL SHORT MEASURING 4.3MM
|
Facility
|
OP
|
$1,600.00
|
|
| Hospital Charge Code |
270694082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Aetna Commercial |
$480.00
|
| Rate for Payer: Aetna Medicare Advantage |
$480.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$408.00
|
| Rate for Payer: Cigna Commercial |
$800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.00
|
| Rate for Payer: Oxford Commercial |
$800.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$800.00
|
|
|
DRILL SHORT MEASURING 4.3MM
|
Facility
|
IP
|
$1,600.00
|
|
| Hospital Charge Code |
270694082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
|
|
DRILL SKULL FOR IMPLANTATION
|
Facility
|
IP
|
$2,647.00
|
|
|
Service Code
|
HCPCS 61107
|
| Hospital Charge Code |
1600000644
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$397.05 |
| Max. Negotiated Rate |
$397.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$397.05
|
|
|
DRILL SKULL FOR IMPLANTATION
|
Facility
|
OP
|
$2,647.00
|
|
|
Service Code
|
HCPCS 61107
|
| Hospital Charge Code |
1600000644
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$311.55 |
| Max. Negotiated Rate |
$6,873.00 |
| Rate for Payer: Aetna Commercial |
$794.10
|
| Rate for Payer: Aetna Medicare Advantage |
$794.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$674.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$674.99
|
| 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 |
$674.99
|
| Rate for Payer: Cigna Commercial |
$311.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$344.11
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$397.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
DRILL SLEEVE DBL 2.7/1.25MM
|
Facility
|
OP
|
$1,713.00
|
|
| Hospital Charge Code |
270676251
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$222.69 |
| Max. Negotiated Rate |
$856.50 |
| Rate for Payer: Aetna Commercial |
$513.90
|
| Rate for Payer: Aetna Medicare Advantage |
$513.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.81
|
| Rate for Payer: Cigna Commercial |
$856.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.69
|
| Rate for Payer: Oxford Commercial |
$856.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$856.50
|
|
|
DRILL SLEEVE DBL 2.7/1.25MM
|
Facility
|
IP
|
$1,713.00
|
|
| Hospital Charge Code |
270676251
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$256.95 |
| Max. Negotiated Rate |
$256.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.95
|
|
|
DRILL SLEEVE DOUBLE 4.5/3.2MM
|
Facility
|
OP
|
$1,395.00
|
|
| Hospital Charge Code |
270671822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$181.35 |
| Max. Negotiated Rate |
$697.50 |
| Rate for Payer: Aetna Commercial |
$418.50
|
| Rate for Payer: Aetna Medicare Advantage |
$418.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$355.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$355.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$355.73
|
| Rate for Payer: Cigna Commercial |
$697.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.35
|
| Rate for Payer: Oxford Commercial |
$697.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$209.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.50
|
|
|
DRILL SLEEVE DOUBLE 4.5/3.2MM
|
Facility
|
IP
|
$1,395.00
|
|
| Hospital Charge Code |
270671822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$209.25 |
| Max. Negotiated Rate |
$209.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$209.25
|
|
|
DRILL SLEEVE SHORT 6.0/5.0MM
|
Facility
|
IP
|
$565.45
|
|
| Hospital Charge Code |
270641668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.82 |
| Max. Negotiated Rate |
$84.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.82
|
|
|
DRILL SLEEVE SHORT 6.0/5.0MM
|
Facility
|
OP
|
$565.45
|
|
| Hospital Charge Code |
270641668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.51 |
| Max. Negotiated Rate |
$282.73 |
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna Medicare Advantage |
$169.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.19
|
| Rate for Payer: Cigna Commercial |
$282.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.51
|
| Rate for Payer: Oxford Commercial |
$282.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$282.73
|
|