|
ANCHOR OMEGA PEEK KNTLS 4.75MM
|
Facility
|
OP
|
$4,148.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.25 |
| Max. Negotiated Rate |
$2,074.18 |
| Rate for Payer: Aetna Commercial |
$1,244.51
|
| Rate for Payer: Aetna Medicare Advantage |
$1,244.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$829.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.83
|
| Rate for Payer: Cigna Commercial |
$2,074.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,003.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$622.25
|
|
|
ANCHOR PEEK HIP
|
Facility
|
IP
|
$2,025.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$490.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$405.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$490.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
ANCHOR PEEK HIP
|
Facility
|
OP
|
$2,025.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$607.50
|
| Rate for Payer: Aetna Medicare Advantage |
$607.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$405.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.38
|
| Rate for Payer: Cigna Commercial |
$1,012.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$490.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
ANCHOR PEEK ZIP 5.5m3910200035
|
Facility
|
OP
|
$1,135.40
|
|
| Hospital Charge Code |
270641990
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.31 |
| Max. Negotiated Rate |
$567.70 |
| Rate for Payer: Aetna Commercial |
$340.62
|
| Rate for Payer: Aetna Medicare Advantage |
$340.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$289.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$289.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$289.53
|
| Rate for Payer: Cigna Commercial |
$567.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.31
|
|
|
ANCHOR PEEK ZIP 5.5m3910200035
|
Facility
|
IP
|
$1,135.40
|
|
| Hospital Charge Code |
270641990
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.31 |
| Max. Negotiated Rate |
$274.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.31
|
|
|
ANCHOR PEEK ZIP 6.5m3910020075
|
Facility
|
IP
|
$1,135.40
|
|
| Hospital Charge Code |
270641991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.31 |
| Max. Negotiated Rate |
$274.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.31
|
|
|
ANCHOR PEEK ZIP 6.5m3910020075
|
Facility
|
OP
|
$1,135.40
|
|
| Hospital Charge Code |
270641991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.31 |
| Max. Negotiated Rate |
$567.70 |
| Rate for Payer: Aetna Commercial |
$340.62
|
| Rate for Payer: Aetna Medicare Advantage |
$340.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$289.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$289.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$289.53
|
| Rate for Payer: Cigna Commercial |
$567.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.31
|
|
|
ANCHOR PEG GLENIOD 48MM
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270685581
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
ANCHOR PEG GLENIOD 48MM
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270685581
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$1,800.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,530.00
|
| Rate for Payer: Cigna Commercial |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
ANCHORPKKNOTLESSSWIVELOCK5.5MM
|
Facility
|
IP
|
$2,175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$326.25 |
| Max. Negotiated Rate |
$526.35 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$435.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$526.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.25
|
|
|
ANCHORPKKNOTLESSSWIVELOCK5.5MM
|
Facility
|
OP
|
$2,175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$326.25 |
| Max. Negotiated Rate |
$1,087.50 |
| Rate for Payer: Aetna Commercial |
$652.50
|
| Rate for Payer: Aetna Medicare Advantage |
$652.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$554.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$554.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$554.62
|
| Rate for Payer: Cigna Commercial |
$1,087.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$526.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.25
|
|
|
ANCHOR PLUS QUICK W/2-0 SUTURE
|
Facility
|
OP
|
$1,460.00
|
|
| Hospital Charge Code |
270638832
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$730.00 |
| Rate for Payer: Aetna Commercial |
$438.00
|
| Rate for Payer: Aetna Medicare Advantage |
$438.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$372.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$372.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$372.30
|
| Rate for Payer: Cigna Commercial |
$730.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$189.80
|
| Rate for Payer: Oxford Commercial |
$730.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$730.00
|
|
|
ANCHOR PLUS QUICK W/2-0 SUTURE
|
Facility
|
IP
|
$1,460.00
|
|
| Hospital Charge Code |
270638832
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.00 |
| Max. Negotiated Rate |
$219.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.00
|
|
|
ANCHOR QUICK SUTURE
|
Facility
|
OP
|
$1,555.00
|
|
| Hospital Charge Code |
2706582621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.15 |
| Max. Negotiated Rate |
$777.50 |
| Rate for Payer: Aetna Commercial |
$466.50
|
| Rate for Payer: Aetna Medicare Advantage |
$466.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$396.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$396.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$396.52
|
| Rate for Payer: Cigna Commercial |
$777.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$202.15
|
| Rate for Payer: Oxford Commercial |
$777.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$777.50
|
|
|
ANCHOR QUICK SUTURE
|
Facility
|
IP
|
$1,555.00
|
|
| Hospital Charge Code |
2706582621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.25 |
| Max. Negotiated Rate |
$233.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.25
|
|
|
ANCHOR QUK GII POLY 36 212034
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270633355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$450.00
|
| Rate for Payer: Aetna Medicare Advantage |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
ANCHOR QUK GII POLY 36 212034
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270633355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
ANCHOR REELX STT 4.5MM
|
Facility
|
IP
|
$1,923.75
|
|
| Hospital Charge Code |
270676526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$288.56 |
| Max. Negotiated Rate |
$288.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.56
|
|
|
ANCHOR REELX STT 4.5MM
|
Facility
|
OP
|
$1,923.75
|
|
| Hospital Charge Code |
270676526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.09 |
| Max. Negotiated Rate |
$961.88 |
| Rate for Payer: Aetna Commercial |
$577.12
|
| Rate for Payer: Aetna Medicare Advantage |
$577.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$490.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$490.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$490.56
|
| Rate for Payer: Cigna Commercial |
$961.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.09
|
| Rate for Payer: Oxford Commercial |
$961.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$961.88
|
|
|
ANCHOR ROTATOR CUFF SZ 212031
|
Facility
|
OP
|
$2,036.85
|
|
| Hospital Charge Code |
270601991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$305.53 |
| Max. Negotiated Rate |
$1,018.42 |
| Rate for Payer: Aetna Commercial |
$611.05
|
| Rate for Payer: Aetna Medicare Advantage |
$611.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$519.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$519.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$407.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$519.40
|
| Rate for Payer: Cigna Commercial |
$1,018.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$492.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$305.53
|
|
|
ANCHOR ROTATOR CUFF SZ 212031
|
Facility
|
IP
|
$2,036.85
|
|
| Hospital Charge Code |
270601991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$305.53 |
| Max. Negotiated Rate |
$492.92 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$407.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$492.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$305.53
|
|
|
ANCHOR SONIC KIT 2.5 x10mm #0
|
Facility
|
OP
|
$2,025.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$607.50
|
| Rate for Payer: Aetna Medicare Advantage |
$607.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$405.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.38
|
| Rate for Payer: Cigna Commercial |
$1,012.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$490.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
ANCHOR SONIC KIT 2.5 x10mm #0
|
Facility
|
IP
|
$2,025.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$490.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$405.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$490.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
ANCHOR SPILK WORTHO 5 0 222986
|
Facility
|
IP
|
$1,715.00
|
|
| Hospital Charge Code |
270638181
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$257.25 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$257.25
|
|
|
ANCHOR SPILK WORTHO 5 0 222986
|
Facility
|
OP
|
$1,715.00
|
|
| Hospital Charge Code |
270638181
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$222.95 |
| Max. Negotiated Rate |
$857.50 |
| Rate for Payer: Aetna Commercial |
$514.50
|
| Rate for Payer: Aetna Medicare Advantage |
$514.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.32
|
| Rate for Payer: Cigna Commercial |
$857.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.95
|
| Rate for Payer: Oxford Commercial |
$857.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$257.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$857.50
|
|