|
KNIFE J-PLASMA
|
Facility
|
OP
|
$939.00
|
|
| Hospital Charge Code |
270658234
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$122.07 |
| Max. Negotiated Rate |
$469.50 |
| Rate for Payer: Aetna Commercial |
$281.70
|
| Rate for Payer: Aetna Medicare Advantage |
$281.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$239.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$239.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$239.44
|
| Rate for Payer: Cigna Commercial |
$469.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$122.07
|
| Rate for Payer: Oxford Commercial |
$469.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$469.50
|
|
|
KNIFE J-PLASMA
|
Facility
|
IP
|
$939.00
|
|
| Hospital Charge Code |
270658234
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$140.85 |
| Max. Negotiated Rate |
$140.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.85
|
|
|
KNIFE LIF
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270702572
|
|
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
|
|
|
KNIFE LIF
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270702572
|
|
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
|
|
|
KNIFE LVTC ARTHRO BANANA SERR
|
Facility
|
OP
|
$580.85
|
|
| Hospital Charge Code |
270600343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.51 |
| Max. Negotiated Rate |
$290.43 |
| Rate for Payer: Aetna Commercial |
$174.25
|
| Rate for Payer: Aetna Medicare Advantage |
$174.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$148.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$148.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$148.12
|
| Rate for Payer: Cigna Commercial |
$290.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.51
|
| Rate for Payer: Oxford Commercial |
$290.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$290.43
|
|
|
KNIFE LVTC ARTHRO BANANA SERR
|
Facility
|
IP
|
$580.85
|
|
| Hospital Charge Code |
270600343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$87.13 |
| Max. Negotiated Rate |
$87.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.13
|
|
|
KNIFE MICROSURGERY
|
Facility
|
IP
|
$204.15
|
|
| Hospital Charge Code |
270675324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.62 |
| Max. Negotiated Rate |
$30.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.62
|
|
|
KNIFE MICROSURGERY
|
Facility
|
OP
|
$204.15
|
|
| Hospital Charge Code |
270675324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.54 |
| Max. Negotiated Rate |
$102.08 |
| Rate for Payer: Aetna Commercial |
$61.24
|
| Rate for Payer: Aetna Medicare Advantage |
$61.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.06
|
| Rate for Payer: Cigna Commercial |
$102.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.54
|
| Rate for Payer: Oxford Commercial |
$102.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$102.08
|
|
|
KNIFE MICRO-UNITOME 22.5
|
Facility
|
OP
|
$71.00
|
|
| Hospital Charge Code |
270335133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$35.50 |
| Rate for Payer: Aetna Commercial |
$21.30
|
| Rate for Payer: Aetna Medicare Advantage |
$21.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.11
|
| Rate for Payer: Cigna Commercial |
$35.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.23
|
| Rate for Payer: Oxford Commercial |
$35.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$35.50
|
|
|
KNIFE MICRO-UNITOME 22.5
|
Facility
|
IP
|
$71.00
|
|
| Hospital Charge Code |
270335133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$10.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
|
|
KNIFE MTK ACL GRAFT 10 200701
|
Facility
|
OP
|
$950.00
|
|
| Hospital Charge Code |
270625067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$285.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$242.25
|
| Rate for Payer: Cigna Commercial |
$475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$123.50
|
| Rate for Payer: Oxford Commercial |
$475.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$475.00
|
|
|
KNIFE MTK ACL GRAFT 10 200701
|
Facility
|
IP
|
$950.00
|
|
| Hospital Charge Code |
270625067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
|
|
KNIFE OPHTHALMIC CURVED 6/BX
|
Facility
|
IP
|
$111.65
|
|
| Hospital Charge Code |
270650725
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$16.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.75
|
|
|
KNIFE OPHTHALMIC CURVED 6/BX
|
Facility
|
OP
|
$111.65
|
|
| Hospital Charge Code |
270650725
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.51 |
| Max. Negotiated Rate |
$55.83 |
| Rate for Payer: Aetna Commercial |
$33.49
|
| Rate for Payer: Aetna Medicare Advantage |
$33.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.47
|
| Rate for Payer: Cigna Commercial |
$55.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.51
|
| Rate for Payer: Oxford Commercial |
$55.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.83
|
|
|
KNIFE OPHTHALMIC SLIT 2.4MM AN
|
Facility
|
IP
|
$232.75
|
|
| Hospital Charge Code |
270655842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.91 |
| Max. Negotiated Rate |
$34.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.91
|
|
|
KNIFE OPHTHALMIC SLIT 2.4MM AN
|
Facility
|
OP
|
$232.75
|
|
| Hospital Charge Code |
270655842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.26 |
| Max. Negotiated Rate |
$116.38 |
| Rate for Payer: Aetna Commercial |
$69.83
|
| Rate for Payer: Aetna Medicare Advantage |
$69.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.35
|
| Rate for Payer: Cigna Commercial |
$116.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.26
|
| Rate for Payer: Oxford Commercial |
$116.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$116.38
|
|
|
KNIFE OPHTH SURGN PLS ULTTHN**
|
Facility
|
OP
|
$40.00
|
|
| Hospital Charge Code |
1600907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna Commercial |
$12.00
|
| Rate for Payer: Aetna Medicare Advantage |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.20
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.20
|
| Rate for Payer: Oxford Commercial |
$20.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.00
|
|
|
KNIFE OPHTH SURGN PLS ULTTHN**
|
Facility
|
IP
|
$40.00
|
|
| Hospital Charge Code |
1600907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
KNIFE OPTHALMIC 15 DEGREE
|
Facility
|
IP
|
$62.00
|
|
| Hospital Charge Code |
270335131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$9.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.30
|
|
|
KNIFE OPTHALMIC 15 DEGREE
|
Facility
|
OP
|
$62.00
|
|
| Hospital Charge Code |
270335131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.06 |
| Max. Negotiated Rate |
$31.00 |
| Rate for Payer: Aetna Commercial |
$18.60
|
| Rate for Payer: Aetna Medicare Advantage |
$18.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.81
|
| Rate for Payer: Cigna Commercial |
$31.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.06
|
| Rate for Payer: Oxford Commercial |
$31.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.00
|
|
|
KNIFE OPTHALMIC 57
|
Facility
|
OP
|
$203.00
|
|
| Hospital Charge Code |
270335134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.39 |
| Max. Negotiated Rate |
$101.50 |
| Rate for Payer: Aetna Commercial |
$60.90
|
| Rate for Payer: Aetna Medicare Advantage |
$60.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.77
|
| Rate for Payer: Cigna Commercial |
$101.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.39
|
| Rate for Payer: Oxford Commercial |
$101.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$101.50
|
|
|
KNIFE OPTHALMIC 57
|
Facility
|
IP
|
$203.00
|
|
| Hospital Charge Code |
270335134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.45 |
| Max. Negotiated Rate |
$30.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
|
|
KNIFE PHACO SLIT PAK 3.2 MM
|
Facility
|
IP
|
$394.90
|
|
| Hospital Charge Code |
270654249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$59.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
|
|
KNIFE PHACO SLIT PAK 3.2 MM
|
Facility
|
OP
|
$394.90
|
|
| Hospital Charge Code |
270654249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.34 |
| Max. Negotiated Rate |
$197.45 |
| Rate for Payer: Aetna Commercial |
$118.47
|
| Rate for Payer: Aetna Medicare Advantage |
$118.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.70
|
| Rate for Payer: Cigna Commercial |
$197.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.34
|
| Rate for Payer: Oxford Commercial |
$197.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$197.45
|
|
|
KNIFE SACHSE COLD STR
|
Facility
|
IP
|
$811.97
|
|
| Hospital Charge Code |
270644707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$121.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.80
|
|