|
SAW BLADE 4x15x0.4MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.41 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$95.55
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.41
|
| Rate for Payer: Oxford Commercial |
$159.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.25
|
|
|
SAW BLADE 4x15x0.4MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 4x15x0.4MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.23 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$99.75
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.23
|
| Rate for Payer: Oxford Commercial |
$166.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$166.25
|
|
|
SAW BLADE 4x15x0.4MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 50x70x0.8MM CUT
|
Facility
|
OP
|
$290.50
|
|
| Hospital Charge Code |
270674804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.77 |
| Max. Negotiated Rate |
$145.25 |
| Rate for Payer: Aetna Commercial |
$87.15
|
| Rate for Payer: Aetna Medicare Advantage |
$87.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$74.08
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.77
|
| Rate for Payer: Oxford Commercial |
$145.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$145.25
|
|
|
SAW BLADE 50x70x0.8MM CUT
|
Facility
|
IP
|
$290.50
|
|
| Hospital Charge Code |
270674804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$43.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
|
|
SAW BLADE 512.50 26/0.65 C/THK
|
Facility
|
OP
|
$336.00
|
|
| Hospital Charge Code |
270674773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.68 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$100.80
|
| Rate for Payer: Aetna Medicare Advantage |
$100.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$85.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$85.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$85.68
|
| Rate for Payer: Cigna Commercial |
$168.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.68
|
| Rate for Payer: Oxford Commercial |
$168.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$168.00
|
|
|
SAW BLADE 512.50 26/0.65 C/THK
|
Facility
|
IP
|
$336.00
|
|
| Hospital Charge Code |
270674773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.40
|
|
|
SAW BLADE 60MMx25MM 0.89MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 60MMx25MM 0.89MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.05 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$115.50
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.05
|
| Rate for Payer: Oxford Commercial |
$192.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$192.50
|
|
|
SAW BLADE 6MM W 13MM L/0.25MM
|
Facility
|
OP
|
$336.00
|
|
| Hospital Charge Code |
270674774
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.68 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$100.80
|
| Rate for Payer: Aetna Medicare Advantage |
$100.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$85.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$85.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$85.68
|
| Rate for Payer: Cigna Commercial |
$168.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.68
|
| Rate for Payer: Oxford Commercial |
$168.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$168.00
|
|
|
SAW BLADE 6MM W 13MM L/0.25MM
|
Facility
|
IP
|
$336.00
|
|
| Hospital Charge Code |
270674774
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.40
|
|
|
SAW BLADE 6x10x0.4MM CUT
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.23 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$99.75
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.23
|
| Rate for Payer: Oxford Commercial |
$166.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$166.25
|
|
|
SAW BLADE 6x10x0.4MM CUT
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 6x25x0.6MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.41 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$95.55
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.41
|
| Rate for Payer: Oxford Commercial |
$159.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.25
|
|
|
SAW BLADE 6x25x0.6MM CUT
|
Facility
|
OP
|
$290.50
|
|
| Hospital Charge Code |
270674807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.77 |
| Max. Negotiated Rate |
$145.25 |
| Rate for Payer: Aetna Commercial |
$87.15
|
| Rate for Payer: Aetna Medicare Advantage |
$87.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$74.08
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.77
|
| Rate for Payer: Oxford Commercial |
$145.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$145.25
|
|
|
SAW BLADE 6x25x0.6MM CUT
|
Facility
|
IP
|
$290.50
|
|
| Hospital Charge Code |
270674807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$43.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
|
|
SAW BLADE 6x25x0.6MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 6x25x0.6MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 6x25x0.6MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.23 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$99.75
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.23
|
| Rate for Payer: Oxford Commercial |
$166.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$166.25
|
|
|
SAW BLADE 6x30x0.4MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.41 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$95.55
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.41
|
| Rate for Payer: Oxford Commercial |
$159.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.25
|
|
|
SAW BLADE 6x30x0.4MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 6x30x0.4MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.23 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$99.75
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.23
|
| Rate for Payer: Oxford Commercial |
$166.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$166.25
|
|
|
SAW BLADE 6x30x0.4MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 70MM NARROW
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
270669434
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.50
|
| Rate for Payer: Oxford Commercial |
$375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$375.00
|
|