|
REAMER HEAD 18.5 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691495
|
|
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 18.5 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691495
|
|
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 19.0 MM MEDULLARY
|
Facility
|
IP
|
$1,633.85
|
|
| Hospital Charge Code |
270691496
|
|
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 19.0 MM MEDULLARY
|
Facility
|
OP
|
$1,633.85
|
|
| Hospital Charge Code |
270691496
|
|
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 ANGLE S
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270699161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$221.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
REAMER HEAD ANGLE S
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270699161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$191.75 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$442.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$191.75
|
| Rate for Payer: Oxford Commercial |
$737.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$737.50
|
|
|
REAMER HEADED CANNULATED 10MM
|
Facility
|
OP
|
$1,130.00
|
|
| Hospital Charge Code |
270601370
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.90 |
| Max. Negotiated Rate |
$565.00 |
| Rate for Payer: Aetna Commercial |
$339.00
|
| Rate for Payer: Aetna Medicare Advantage |
$339.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$288.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$288.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$288.15
|
| Rate for Payer: Cigna Commercial |
$565.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$146.90
|
| Rate for Payer: Oxford Commercial |
$565.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$565.00
|
|
|
REAMER HEADED CANNULATED 10MM
|
Facility
|
IP
|
$1,130.00
|
|
| Hospital Charge Code |
270601370
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.50 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.50
|
|
|
REAMER HEADED CANNULATED 5.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655167
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 5.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655167
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655166
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655166
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 6.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 6.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 6MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 6MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 7.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 7.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 7MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270636833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 7MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270636833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 8.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655172
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 8.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655172
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 8MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270636064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|
|
REAMER HEADED CANNULATED 8MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270636064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 9.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270673803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$322.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.75
|
| Rate for Payer: Oxford Commercial |
$537.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$537.50
|
|