|
DRILL TWIST 4.0 MM 70 MM PT
|
Facility
|
OP
|
$495.00
|
|
| Hospital Charge Code |
270684002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.35 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$148.50
|
| Rate for Payer: Aetna Medicare Advantage |
$148.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.22
|
| Rate for Payer: Cigna Commercial |
$247.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.35
|
| Rate for Payer: Oxford Commercial |
$247.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$247.50
|
|
|
DRILL TWIST 4.0 MM 70 MM PT
|
Facility
|
IP
|
$495.00
|
|
| Hospital Charge Code |
270684002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.25 |
| Max. Negotiated Rate |
$74.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
|
|
DRILL TWIST 4.3x180 CAL 472068
|
Facility
|
OP
|
$530.00
|
|
| Hospital Charge Code |
270641800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.90 |
| Max. Negotiated Rate |
$265.00 |
| Rate for Payer: Aetna Commercial |
$159.00
|
| Rate for Payer: Aetna Medicare Advantage |
$159.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$135.15
|
| Rate for Payer: Cigna Commercial |
$265.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$68.90
|
| Rate for Payer: Oxford Commercial |
$265.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$265.00
|
|
|
DRILL TWIST 4.3x180 CAL 472068
|
Facility
|
IP
|
$530.00
|
|
| Hospital Charge Code |
270641800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
|
|
DRILL TWIST CALIBR 3.2 472370
|
Facility
|
OP
|
$307.60
|
|
| Hospital Charge Code |
270633334
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.99 |
| Max. Negotiated Rate |
$153.80 |
| Rate for Payer: Aetna Commercial |
$92.28
|
| Rate for Payer: Aetna Medicare Advantage |
$92.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.44
|
| Rate for Payer: Cigna Commercial |
$153.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.99
|
| Rate for Payer: Oxford Commercial |
$153.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.80
|
|
|
DRILL TWIST CALIBR 3.2 472370
|
Facility
|
IP
|
$307.60
|
|
| Hospital Charge Code |
270633334
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.14 |
| Max. Negotiated Rate |
$46.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.14
|
|
|
DRILL TWIST CANNULATED 6.5MM
|
Facility
|
IP
|
$3,455.00
|
|
| Hospital Charge Code |
270661525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$518.25 |
| Max. Negotiated Rate |
$518.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$518.25
|
|
|
DRILL TWIST CANNULATED 6.5MM
|
Facility
|
OP
|
$3,455.00
|
|
| Hospital Charge Code |
270661525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$449.15 |
| Max. Negotiated Rate |
$1,727.50 |
| Rate for Payer: Aetna Commercial |
$1,036.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,036.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$881.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$881.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$881.02
|
| Rate for Payer: Cigna Commercial |
$1,727.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$449.15
|
| Rate for Payer: Oxford Commercial |
$1,727.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$518.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,727.50
|
|
|
DRILL VOER AQ 3.5 X 13CM
|
Facility
|
OP
|
$852.50
|
|
| Hospital Charge Code |
270701954
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.83 |
| Max. Negotiated Rate |
$426.25 |
| Rate for Payer: Aetna Commercial |
$255.75
|
| Rate for Payer: Aetna Medicare Advantage |
$255.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$217.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$217.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$217.39
|
| Rate for Payer: Cigna Commercial |
$426.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.83
|
| Rate for Payer: Oxford Commercial |
$426.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$127.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$426.25
|
|
|
DRILL VOER AQ 3.5 X 13CM
|
Facility
|
IP
|
$852.50
|
|
| Hospital Charge Code |
270701954
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.88 |
| Max. Negotiated Rate |
$127.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$127.88
|
|
|
DRILL W AO2.0MM
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Aetna Commercial |
$360.00
|
| Rate for Payer: Aetna Medicare Advantage |
$360.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$306.00
|
| Rate for Payer: Cigna Commercial |
$600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$290.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
|
|
DRILL W AO2.0MM
|
Facility
|
IP
|
$1,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$290.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$240.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$290.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
|
|
DRILL WLZ TWIST 1.5 50 019195
|
Facility
|
OP
|
$460.85
|
|
| Hospital Charge Code |
270620858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$230.43 |
| Rate for Payer: Aetna Commercial |
$138.25
|
| Rate for Payer: Aetna Medicare Advantage |
$138.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$117.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$117.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$117.52
|
| Rate for Payer: Cigna Commercial |
$230.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.91
|
| Rate for Payer: Oxford Commercial |
$230.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$230.43
|
|
|
DRILL WLZ TWIST 1.5 50 019195
|
Facility
|
IP
|
$460.85
|
|
| Hospital Charge Code |
270620858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.13 |
| Max. Negotiated Rate |
$69.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.13
|
|
|
DRILL WLZ TWIST 1.5 70 10MM
|
Facility
|
OP
|
$718.45
|
|
| Hospital Charge Code |
270607816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.40 |
| Max. Negotiated Rate |
$359.23 |
| Rate for Payer: Aetna Commercial |
$215.53
|
| Rate for Payer: Aetna Medicare Advantage |
$215.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$183.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$183.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$183.20
|
| Rate for Payer: Cigna Commercial |
$359.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.40
|
| Rate for Payer: Oxford Commercial |
$359.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$359.23
|
|
|
DRILL WLZ TWIST 1.5 70 10MM
|
Facility
|
IP
|
$718.45
|
|
| Hospital Charge Code |
270607816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.77 |
| Max. Negotiated Rate |
$107.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.77
|
|
|
DRILL ZIM FEM 5.0 2255-31-50
|
Facility
|
OP
|
$805.65
|
|
| Hospital Charge Code |
270620532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.73 |
| Max. Negotiated Rate |
$402.82 |
| Rate for Payer: Aetna Commercial |
$241.69
|
| Rate for Payer: Aetna Medicare Advantage |
$241.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$205.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$205.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$205.44
|
| Rate for Payer: Cigna Commercial |
$402.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$104.73
|
| Rate for Payer: Oxford Commercial |
$402.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$402.82
|
|
|
DRILL ZIM FEM 5.0 2255-31-50
|
Facility
|
IP
|
$805.65
|
|
| Hospital Charge Code |
270620532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.85 |
| Max. Negotiated Rate |
$120.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.85
|
|
|
DRILL ZIM PILOT 5.0 2253350
|
Facility
|
IP
|
$695.00
|
|
| Hospital Charge Code |
270625707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.25 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
|
|
DRILL ZIM PILOT 5.0 2253350
|
Facility
|
OP
|
$695.00
|
|
| Hospital Charge Code |
270625707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.35 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Aetna Commercial |
$208.50
|
| Rate for Payer: Aetna Medicare Advantage |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$177.22
|
| Rate for Payer: Cigna Commercial |
$347.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.35
|
| Rate for Payer: Oxford Commercial |
$347.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$347.50
|
|
|
DRILL ZIM QC 3.2MM 2410-032
|
Facility
|
IP
|
$248.85
|
|
| Hospital Charge Code |
270601277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$37.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.33
|
|
|
DRILL ZIM QC 3.2MM 2410-032
|
Facility
|
OP
|
$248.85
|
|
| Hospital Charge Code |
270601277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.35 |
| Max. Negotiated Rate |
$124.42 |
| Rate for Payer: Aetna Commercial |
$74.66
|
| Rate for Payer: Aetna Medicare Advantage |
$74.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.46
|
| Rate for Payer: Cigna Commercial |
$124.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.35
|
| Rate for Payer: Oxford Commercial |
$124.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.42
|
|
|
DRILL ZIM QC 4.5MM 2410-045
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270610453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.10
|
| Rate for Payer: Oxford Commercial |
$69.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$69.62
|
|
|
DRILL ZIM QC 4.5MM 2410-045
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270610453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
DRILL ZIM TWIST 3.2/127MM
|
Facility
|
IP
|
$172.85
|
|
| Hospital Charge Code |
270608663
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.93 |
| Max. Negotiated Rate |
$25.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.93
|
|