|
REAMER LONG CANN 3.2MM
|
Facility
|
IP
|
$812.50
|
|
| Hospital Charge Code |
270698516
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.88 |
| Max. Negotiated Rate |
$121.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.88
|
|
|
REAMER LONG CANN 3.2MM
|
Facility
|
OP
|
$812.50
|
|
| Hospital Charge Code |
270698516
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.62 |
| Max. Negotiated Rate |
$406.25 |
| Rate for Payer: Aetna Commercial |
$243.75
|
| Rate for Payer: Aetna Medicare Advantage |
$243.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.19
|
| Rate for Payer: Cigna Commercial |
$406.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.62
|
| Rate for Payer: Oxford Commercial |
$406.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$406.25
|
|
|
REAMER LONG CANN 4.0MM
|
Facility
|
OP
|
$1,218.75
|
|
| Hospital Charge Code |
270698974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.44 |
| Max. Negotiated Rate |
$609.38 |
| Rate for Payer: Aetna Commercial |
$365.62
|
| Rate for Payer: Aetna Medicare Advantage |
$365.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.78
|
| Rate for Payer: Cigna Commercial |
$609.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$158.44
|
| Rate for Payer: Oxford Commercial |
$609.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$182.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$609.38
|
|
|
REAMER LONG CANN 4.0MM
|
Facility
|
IP
|
$1,218.75
|
|
| Hospital Charge Code |
270698974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$182.81 |
| Max. Negotiated Rate |
$182.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$182.81
|
|
|
REAMER LOW PROFILE 10.5MM STER
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270678477
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
REAMER LOW PROFILE 10.5MM STER
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270678477
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
REAMER LOW PROFILE 10MM STR
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270646570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
REAMER LOW PROFILE 10MM STR
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270646570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
REAMER LOW PROFILE 11MM
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270675209
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
REAMER LOW PROFILE 11MM
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270675209
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
REAMER LOW PROFILE 8MM
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270678476
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
REAMER LOW PROFILE 8MM
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270678476
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
REAMER LOW PROFILE 9MM
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270675208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
REAMER LOW PROFILE 9MM
|
Facility
|
OP
|
$2,175.00
|
|
| Hospital Charge Code |
270668500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$282.75 |
| 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) PPO |
$554.62
|
| Rate for Payer: Cigna Commercial |
$1,087.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$282.75
|
| Rate for Payer: Oxford Commercial |
$1,087.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,087.50
|
|
|
REAMER LOW PROFILE 9MM
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270675208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
REAMER LOW PROFILE 9MM
|
Facility
|
IP
|
$2,175.00
|
|
| Hospital Charge Code |
270668500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$326.25 |
| Max. Negotiated Rate |
$326.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.25
|
|
|
REAMER MEDULLARY 12.5mm
|
Facility
|
OP
|
$1,248.00
|
|
| Hospital Charge Code |
270656602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.24 |
| Max. Negotiated Rate |
$624.00 |
| Rate for Payer: Aetna Commercial |
$374.40
|
| Rate for Payer: Aetna Medicare Advantage |
$374.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$318.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$318.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$318.24
|
| Rate for Payer: Cigna Commercial |
$624.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.24
|
| Rate for Payer: Oxford Commercial |
$624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$624.00
|
|
|
REAMER MEDULLARY 12.5mm
|
Facility
|
IP
|
$1,248.00
|
|
| Hospital Charge Code |
270656602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$187.20 |
| Max. Negotiated Rate |
$187.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.20
|
|
|
REAMER MEDULLARY 8.5mm
|
Facility
|
IP
|
$1,324.00
|
|
| Hospital Charge Code |
270682876
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$198.60 |
| Max. Negotiated Rate |
$198.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.60
|
|
|
REAMER MEDULLARY 8.5mm
|
Facility
|
OP
|
$1,324.00
|
|
| Hospital Charge Code |
270682876
|
|
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 METATARSAL 16MM
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270674086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$292.50 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$1,125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,125.00
|
|
|
REAMER METATARSAL 16MM
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270674086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270674087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$292.50 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$1,125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,125.00
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
IP
|
$5,750.00
|
|
| Hospital Charge Code |
270669667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$862.50 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
|
|
REAMER METATARSAL 18MM
|
Facility
|
OP
|
$5,750.00
|
|
| Hospital Charge Code |
270669667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$747.50 |
| Max. Negotiated Rate |
$2,875.00 |
| Rate for Payer: Aetna Commercial |
$1,725.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,466.25
|
| Rate for Payer: Cigna Commercial |
$2,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$747.50
|
| Rate for Payer: Oxford Commercial |
$2,875.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,875.00
|
|