|
REAMER PATELLA SZ 46 59799546
|
Facility
|
IP
|
$878.00
|
|
| Hospital Charge Code |
270633882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.70 |
| Max. Negotiated Rate |
$131.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.70
|
|
|
REAMER PATELLA SZ 46 59799546
|
Facility
|
OP
|
$878.00
|
|
| Hospital Charge Code |
270633882
|
|
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 PATLA SZ41 W/P 59799541
|
Facility
|
IP
|
$730.50
|
|
| Hospital Charge Code |
270634605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.58 |
| Max. Negotiated Rate |
$109.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.58
|
|
|
REAMER PATLA SZ41 W/P 59799541
|
Facility
|
OP
|
$730.50
|
|
| Hospital Charge Code |
270634605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.97 |
| Max. Negotiated Rate |
$365.25 |
| Rate for Payer: Aetna Commercial |
$219.15
|
| Rate for Payer: Aetna Medicare Advantage |
$219.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$186.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$186.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$186.28
|
| Rate for Payer: Cigna Commercial |
$365.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.97
|
| Rate for Payer: Oxford Commercial |
$365.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$365.25
|
|
|
REAMER PATL SZ 51 W/P 59799551
|
Facility
|
IP
|
$730.50
|
|
| Hospital Charge Code |
270634655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.58 |
| Max. Negotiated Rate |
$109.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.58
|
|
|
REAMER PATL SZ 51 W/P 59799551
|
Facility
|
OP
|
$730.50
|
|
| Hospital Charge Code |
270634655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.97 |
| Max. Negotiated Rate |
$365.25 |
| Rate for Payer: Aetna Commercial |
$219.15
|
| Rate for Payer: Aetna Medicare Advantage |
$219.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$186.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$186.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$186.28
|
| Rate for Payer: Cigna Commercial |
$365.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.97
|
| Rate for Payer: Oxford Commercial |
$365.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$365.25
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
IP
|
$5,750.00
|
|
| Hospital Charge Code |
270669666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$862.50 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270674088
|
|
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 PHALANGEAL 16MM
|
Facility
|
OP
|
$5,750.00
|
|
| Hospital Charge Code |
270669666
|
|
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
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270674088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REAMER PILOTED HEADED 7.5MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270674132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.25 |
| Max. Negotiated Rate |
$512.50 |
| Rate for Payer: Aetna Commercial |
$307.50
|
| Rate for Payer: Aetna Medicare Advantage |
$307.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$261.38
|
| Rate for Payer: Cigna Commercial |
$512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.25
|
| Rate for Payer: Oxford Commercial |
$512.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$512.50
|
|
|
REAMER PILOTED HEADED 7.5MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270674132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER PILOTED HEADED 8.5MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270674131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
REAMER PILOTED HEADED 8.5MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270674131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$190.45 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$439.50
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$190.45
|
| Rate for Payer: Oxford Commercial |
$732.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$732.50
|
|
|
REAMER PILOT HEADED 7MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270675256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER PILOT HEADED 7MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270675256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.25 |
| Max. Negotiated Rate |
$512.50 |
| Rate for Payer: Aetna Commercial |
$307.50
|
| Rate for Payer: Aetna Medicare Advantage |
$307.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$261.38
|
| Rate for Payer: Cigna Commercial |
$512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.25
|
| Rate for Payer: Oxford Commercial |
$512.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$512.50
|
|
|
REAMER PILOT HEADED 8MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270675258
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.25 |
| Max. Negotiated Rate |
$512.50 |
| Rate for Payer: Aetna Commercial |
$307.50
|
| Rate for Payer: Aetna Medicare Advantage |
$307.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$261.38
|
| Rate for Payer: Cigna Commercial |
$512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.25
|
| Rate for Payer: Oxford Commercial |
$512.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$512.50
|
|
|
REAMER PILOT HEADED 8MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270675258
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER PROXIMAL
|
Facility
|
IP
|
$2,009.80
|
|
| Hospital Charge Code |
270689912
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.47 |
| Max. Negotiated Rate |
$301.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.47
|
|
|
REAMER PROXIMAL
|
Facility
|
OP
|
$2,009.80
|
|
| Hospital Charge Code |
270689912
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.27 |
| Max. Negotiated Rate |
$1,004.90 |
| Rate for Payer: Aetna Commercial |
$602.94
|
| Rate for Payer: Aetna Medicare Advantage |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$512.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$512.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$512.50
|
| Rate for Payer: Cigna Commercial |
$1,004.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$261.27
|
| Rate for Payer: Oxford Commercial |
$1,004.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,004.90
|
|
|
REAMER RVS SHOULDER
|
Facility
|
IP
|
$1,501.50
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270696620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.22 |
| Max. Negotiated Rate |
$225.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.22
|
|
|
REAMER RVS SHOULDER
|
Facility
|
OP
|
$1,501.50
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270696620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$195.19 |
| Max. Negotiated Rate |
$750.75 |
| Rate for Payer: Aetna Commercial |
$450.45
|
| Rate for Payer: Aetna Medicare Advantage |
$450.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.88
|
| Rate for Payer: Cigna Commercial |
$750.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.19
|
| Rate for Payer: Oxford Commercial |
$750.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$750.75
|
|
|
REAMER SHAFT 8x450 0227-3000S
|
Facility
|
OP
|
$935.00
|
|
| Hospital Charge Code |
270638647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.55 |
| Max. Negotiated Rate |
$467.50 |
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: Aetna Medicare Advantage |
$280.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$238.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$238.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$238.43
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.55
|
| Rate for Payer: Oxford Commercial |
$467.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$467.50
|
|
|
REAMER SHAFT 8x450 0227-3000S
|
Facility
|
IP
|
$935.00
|
|
| Hospital Charge Code |
270638647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.25 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.25
|
|
|
REAMER SHAFT, MOD.TRINKLE
|
Facility
|
OP
|
$3,315.00
|
|
| Hospital Charge Code |
270656546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$430.95 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$994.50
|
| Rate for Payer: Aetna Medicare Advantage |
$994.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$845.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$845.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$845.33
|
| Rate for Payer: Cigna Commercial |
$1,657.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$430.95
|
| Rate for Payer: Oxford Commercial |
$1,657.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$497.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,657.50
|
|