|
REAMER FLEXIBLE DD -MONOBLOC 6
|
Facility
|
OP
|
$5,508.20
|
|
| Hospital Charge Code |
270694987
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$716.07 |
| Max. Negotiated Rate |
$2,754.10 |
| Rate for Payer: Aetna Commercial |
$1,652.46
|
| Rate for Payer: Aetna Medicare Advantage |
$1,652.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,404.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,404.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,404.59
|
| Rate for Payer: Cigna Commercial |
$2,754.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$716.07
|
| Rate for Payer: Oxford Commercial |
$2,754.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$826.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,754.10
|
|
|
REAMER FLEX W/GUIDE PIN 10mm
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
270681249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$227.50 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$525.00
|
| Rate for Payer: Aetna Medicare Advantage |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$446.25
|
| Rate for Payer: Cigna Commercial |
$875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$227.50
|
| Rate for Payer: Oxford Commercial |
$875.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$875.00
|
|
|
REAMER FLEX W/GUIDE PIN 10mm
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
270681249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$262.50 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
|
|
REAMER FLEX W/GUIDE PIN 9mm
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
270681248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$227.50 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$525.00
|
| Rate for Payer: Aetna Medicare Advantage |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$446.25
|
| Rate for Payer: Cigna Commercial |
$875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$227.50
|
| Rate for Payer: Oxford Commercial |
$875.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$875.00
|
|
|
REAMER FLEX W/GUIDE PIN 9mm
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
270681248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$262.50 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
|
|
REAMER FULLY FLUTED 8mm 232417
|
Facility
|
IP
|
$788.70
|
|
| Hospital Charge Code |
270635837
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.31 |
| Max. Negotiated Rate |
$118.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.31
|
|
|
REAMER FULLY FLUTED 8mm 232417
|
Facility
|
OP
|
$788.70
|
|
| Hospital Charge Code |
270635837
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.53 |
| Max. Negotiated Rate |
$394.35 |
| Rate for Payer: Aetna Commercial |
$236.61
|
| Rate for Payer: Aetna Medicare Advantage |
$236.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$201.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$201.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$201.12
|
| Rate for Payer: Cigna Commercial |
$394.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.53
|
| Rate for Payer: Oxford Commercial |
$394.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$394.35
|
|
|
REAMER FULLY FLUTED 9mm 232419
|
Facility
|
IP
|
$825.00
|
|
| Hospital Charge Code |
270636915
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.75 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.75
|
|
|
REAMER FULLY FLUTED 9mm 232419
|
Facility
|
OP
|
$825.00
|
|
| Hospital Charge Code |
270636915
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.25 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Aetna Commercial |
$247.50
|
| Rate for Payer: Aetna Medicare Advantage |
$247.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$210.38
|
| Rate for Payer: Cigna Commercial |
$412.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$107.25
|
| Rate for Payer: Oxford Commercial |
$412.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$412.50
|
|
|
REAMER HEAD 11.5MM
|
Facility
|
IP
|
$1,324.00
|
|
| Hospital Charge Code |
270683130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$198.60 |
| Max. Negotiated Rate |
$198.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.60
|
|
|
REAMER HEAD 11.5MM
|
Facility
|
OP
|
$1,324.00
|
|
| Hospital Charge Code |
270683130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.12 |
| Max. Negotiated Rate |
$662.00 |
| Rate for Payer: Aetna Commercial |
$397.20
|
| Rate for Payer: Aetna Medicare Advantage |
$397.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$337.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$337.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$337.62
|
| Rate for Payer: Cigna Commercial |
$662.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.12
|
| Rate for Payer: Oxford Commercial |
$662.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$662.00
|
|
|
REAMER HEAD 12.5MM RIA
|
Facility
|
OP
|
$1,452.00
|
|
| Hospital Charge Code |
270671814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.76 |
| Max. Negotiated Rate |
$726.00 |
| Rate for Payer: Aetna Commercial |
$435.60
|
| Rate for Payer: Aetna Medicare Advantage |
$435.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$370.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$370.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$370.26
|
| Rate for Payer: Cigna Commercial |
$726.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Oxford Commercial |
$726.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$726.00
|
|
|
REAMER HEAD 12.5MM RIA
|
Facility
|
IP
|
$1,452.00
|
|
| Hospital Charge Code |
270671814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$217.80 |
| Max. Negotiated Rate |
$217.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.80
|
|
|
REAMER HEAD 12MM STERILE
|
Facility
|
OP
|
$1,452.00
|
|
| Hospital Charge Code |
270675628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.76 |
| Max. Negotiated Rate |
$726.00 |
| Rate for Payer: Aetna Commercial |
$435.60
|
| Rate for Payer: Aetna Medicare Advantage |
$435.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$370.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$370.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$370.26
|
| Rate for Payer: Cigna Commercial |
$726.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.76
|
| Rate for Payer: Oxford Commercial |
$726.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$726.00
|
|
|
REAMER HEAD 12MM STERILE
|
Facility
|
IP
|
$1,452.00
|
|
| Hospital Charge Code |
270675628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$217.80 |
| Max. Negotiated Rate |
$217.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.80
|
|
|
REAMER HEAD 15.5 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$816.92 |
| Rate for Payer: Aetna Commercial |
$490.15
|
| Rate for Payer: Aetna Medicare Advantage |
$490.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$416.63
|
| Rate for Payer: Cigna Commercial |
$816.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.40
|
| Rate for Payer: Oxford Commercial |
$816.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$816.92
|
|
|
REAMER HEAD 15.5 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.08 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
|
|
REAMER HEAD 16.5 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.08 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
|
|
REAMER HEAD 16.5 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$816.92 |
| Rate for Payer: Aetna Commercial |
$490.15
|
| Rate for Payer: Aetna Medicare Advantage |
$490.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$416.63
|
| Rate for Payer: Cigna Commercial |
$816.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.40
|
| Rate for Payer: Oxford Commercial |
$816.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$816.92
|
|
|
REAMER HEAD 17.0 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.08 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
|
|
REAMER HEAD 17.0 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$816.92 |
| Rate for Payer: Aetna Commercial |
$490.15
|
| Rate for Payer: Aetna Medicare Advantage |
$490.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$416.63
|
| Rate for Payer: Cigna Commercial |
$816.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.40
|
| Rate for Payer: Oxford Commercial |
$816.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$816.92
|
|
|
REAMER HEAD 17.5 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$816.92 |
| Rate for Payer: Aetna Commercial |
$490.15
|
| Rate for Payer: Aetna Medicare Advantage |
$490.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$416.63
|
| Rate for Payer: Cigna Commercial |
$816.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.40
|
| Rate for Payer: Oxford Commercial |
$816.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$816.92
|
|
|
REAMER HEAD 17.5 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.08 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
|
|
REAMER HEAD 18.0 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691494
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.08 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
|
|
REAMER HEAD 18.0 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691494
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$816.92 |
| Rate for Payer: Aetna Commercial |
$490.15
|
| Rate for Payer: Aetna Medicare Advantage |
$490.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$416.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$416.63
|
| Rate for Payer: Cigna Commercial |
$816.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$212.40
|
| Rate for Payer: Oxford Commercial |
$816.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$245.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$816.92
|
|