|
REAMER METATARSAL 18MM
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270674087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REAMER MODULAR 10.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MODULAR 10.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 11.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 11.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MODULAR 12.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 12.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MODULAR 8.0MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MODULAR 8.0MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 8.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 8.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MODULAR 9.0MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 9.0MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MODULAR 9.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 9.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$517.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.25
|
| Rate for Payer: Oxford Commercial |
$862.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$862.50
|
|
|
REAMER MTP CUP 18MM GEN 2.455.
|
Facility
|
OP
|
$1,110.00
|
|
| Hospital Charge Code |
270702879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$333.00
|
| Rate for Payer: Aetna Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$283.05
|
| Rate for Payer: Cigna Commercial |
$555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER MTP CUP 18MM GEN 2.455.
|
Facility
|
IP
|
$1,110.00
|
|
| Hospital Charge Code |
270702879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$268.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER MTP CUP 20MM GEN 2.455.
|
Facility
|
OP
|
$1,110.00
|
|
| Hospital Charge Code |
270702880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$333.00
|
| Rate for Payer: Aetna Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$283.05
|
| Rate for Payer: Cigna Commercial |
$555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER MTP CUP 20MM GEN 2.455.
|
Facility
|
IP
|
$1,110.00
|
|
| Hospital Charge Code |
270702880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$268.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER ONE STEP 11.5mm
|
Facility
|
OP
|
$2,950.00
|
|
| Hospital Charge Code |
270646654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$383.50 |
| Max. Negotiated Rate |
$1,475.00 |
| Rate for Payer: Aetna Commercial |
$885.00
|
| Rate for Payer: Aetna Medicare Advantage |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.25
|
| Rate for Payer: Cigna Commercial |
$1,475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$383.50
|
| Rate for Payer: Oxford Commercial |
$1,475.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$442.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,475.00
|
|
|
REAMER ONE STEP 11.5mm
|
Facility
|
IP
|
$2,950.00
|
|
| Hospital Charge Code |
270646654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$442.50 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$442.50
|
|
|
REAMER PATELA 35 W/PH 59799535
|
Facility
|
IP
|
$878.00
|
|
| Hospital Charge Code |
270633243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.70 |
| Max. Negotiated Rate |
$131.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.70
|
|
|
REAMER PATELA 35 W/PH 59799535
|
Facility
|
OP
|
$878.00
|
|
| Hospital Charge Code |
270633243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.14 |
| Max. Negotiated Rate |
$439.00 |
| Rate for Payer: Aetna Commercial |
$263.40
|
| Rate for Payer: Aetna Medicare Advantage |
$263.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.89
|
| Rate for Payer: Cigna Commercial |
$439.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.14
|
| Rate for Payer: Oxford Commercial |
$439.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$439.00
|
|
|
REAMER PATELA 38 W/PH 59799538
|
Facility
|
IP
|
$878.00
|
|
| Hospital Charge Code |
270633242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.70 |
| Max. Negotiated Rate |
$131.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.70
|
|
|
REAMER PATELA 38 W/PH 59799538
|
Facility
|
OP
|
$878.00
|
|
| Hospital Charge Code |
270633242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.14 |
| Max. Negotiated Rate |
$439.00 |
| Rate for Payer: Aetna Commercial |
$263.40
|
| Rate for Payer: Aetna Medicare Advantage |
$263.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.89
|
| Rate for Payer: Cigna Commercial |
$439.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.14
|
| Rate for Payer: Oxford Commercial |
$439.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$439.00
|
|