|
SAW BLADE 90x25.0MM 1.00MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674759
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x25.0MM 1.00MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674759
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x25.0MM 1.07MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674760
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x25.0MM 1.07MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674760
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x25.0MM 1.19MM CUT
|
Facility
|
IP
|
$245.00
|
|
| Hospital Charge Code |
270674761
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
|
|
SAW BLADE 90x25.0MM 1.19MM CUT
|
Facility
|
OP
|
$245.00
|
|
| Hospital Charge Code |
270674761
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna Commercial |
$73.50
|
| Rate for Payer: Aetna Medicare Advantage |
$73.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.48
|
| Rate for Payer: Cigna Commercial |
$122.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.85
|
| Rate for Payer: Oxford Commercial |
$122.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$122.50
|
|
|
SAW BLADE 90x25.0MM 1.27MM CUT
|
Facility
|
IP
|
$245.00
|
|
| Hospital Charge Code |
270674762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
|
|
SAW BLADE 90x25.0MM 1.27MM CUT
|
Facility
|
OP
|
$245.00
|
|
| Hospital Charge Code |
270674762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna Commercial |
$73.50
|
| Rate for Payer: Aetna Medicare Advantage |
$73.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.48
|
| Rate for Payer: Cigna Commercial |
$122.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.85
|
| Rate for Payer: Oxford Commercial |
$122.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$122.50
|
|
|
SAW BLADE 90x25.0MM 1.37MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674763
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x25.0MM 1.37MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674763
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x25.0MM 1.47MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674764
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x25.0MM 1.47MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674764
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 0.89MM
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x9.5-19MM 0.89MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 1.00MM
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674752
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x9.5-19MM 1.00MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674752
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 1.07MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 1.07MM
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x9.5-19MM 1.19MM
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x9.5-19MM 1.19MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 1.27MM
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674755
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x9.5-19MM 1.27MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674755
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 1.37MM
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674756
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$117.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.25
|
|
|
SAW BLADE 90x9.5-19MM 1.37MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674756
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x9.5-19MM 1.47MM
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|