|
SHEAR HS FOCUS 9CM
|
Facility
|
IP
|
$2,895.12
|
|
| Hospital Charge Code |
270673935
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$434.27 |
| Max. Negotiated Rate |
$434.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$434.27
|
|
|
SHEAR LAPROSCOPIC 5mm HARM ACE
|
Facility
|
OP
|
$2,781.29
|
|
| Hospital Charge Code |
270635619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$361.57 |
| Max. Negotiated Rate |
$1,390.64 |
| Rate for Payer: Aetna Commercial |
$834.39
|
| Rate for Payer: Aetna Medicare Advantage |
$834.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$709.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$709.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$709.23
|
| Rate for Payer: Cigna Commercial |
$1,390.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$361.57
|
| Rate for Payer: Oxford Commercial |
$1,390.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$417.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,390.64
|
|
|
SHEAR LAPROSCOPIC 5mm HARM ACE
|
Facility
|
IP
|
$2,781.29
|
|
| Hospital Charge Code |
270635619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$417.19 |
| Max. Negotiated Rate |
$417.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$417.19
|
|
|
SHEARS,COAG.KNIFE DOWN BLADE
|
Facility
|
OP
|
$924.00
|
|
| Hospital Charge Code |
270335397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$277.20
|
| Rate for Payer: Aetna Medicare Advantage |
$277.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$235.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$235.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$235.62
|
| Rate for Payer: Cigna Commercial |
$462.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$120.12
|
| Rate for Payer: Oxford Commercial |
$462.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$462.00
|
|
|
SHEARS,COAG.KNIFE DOWN BLADE
|
Facility
|
IP
|
$924.00
|
|
| Hospital Charge Code |
270335397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.60
|
|
|
SHEARS,COAGULATING PISTALGRIP
|
Facility
|
OP
|
$924.00
|
|
| Hospital Charge Code |
270335399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$277.20
|
| Rate for Payer: Aetna Medicare Advantage |
$277.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$235.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$235.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$235.62
|
| Rate for Payer: Cigna Commercial |
$462.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$120.12
|
| Rate for Payer: Oxford Commercial |
$462.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$462.00
|
|
|
SHEARS,COAGULATING PISTALGRIP
|
Facility
|
IP
|
$924.00
|
|
| Hospital Charge Code |
270335399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.60
|
|
|
SHEARS HARMONIC 1100 20CM
|
Facility
|
OP
|
$5,910.40
|
|
| Hospital Charge Code |
270693525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$768.35 |
| Max. Negotiated Rate |
$2,955.20 |
| Rate for Payer: Aetna Commercial |
$1,773.12
|
| Rate for Payer: Aetna Medicare Advantage |
$1,773.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,507.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,507.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,507.15
|
| Rate for Payer: Cigna Commercial |
$2,955.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$768.35
|
| Rate for Payer: Oxford Commercial |
$2,955.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$886.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,955.20
|
|
|
SHEARS HARMONIC 1100 20CM
|
Facility
|
IP
|
$5,910.40
|
|
| Hospital Charge Code |
270693525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.56 |
| Max. Negotiated Rate |
$886.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$886.56
|
|
|
SHEARS HARMONIC 1100 36CM
|
Facility
|
OP
|
$6,730.15
|
|
| Hospital Charge Code |
270693526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$874.92 |
| Max. Negotiated Rate |
$3,365.07 |
| Rate for Payer: Aetna Commercial |
$2,019.05
|
| Rate for Payer: Aetna Medicare Advantage |
$2,019.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,716.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,716.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,716.19
|
| Rate for Payer: Cigna Commercial |
$3,365.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$874.92
|
| Rate for Payer: Oxford Commercial |
$3,365.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,009.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,365.07
|
|
|
SHEARS HARMONIC 1100 36CM
|
Facility
|
IP
|
$6,730.15
|
|
| Hospital Charge Code |
270693526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,009.52 |
| Max. Negotiated Rate |
$1,009.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,009.52
|
|
|
SHEARS HARMONIC CVD BLADE 36CM
|
Facility
|
OP
|
$2,653.73
|
|
| Hospital Charge Code |
270662788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$344.98 |
| Max. Negotiated Rate |
$1,326.87 |
| Rate for Payer: Aetna Commercial |
$796.12
|
| Rate for Payer: Aetna Medicare Advantage |
$796.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$676.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$676.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$676.70
|
| Rate for Payer: Cigna Commercial |
$1,326.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$344.98
|
| Rate for Payer: Oxford Commercial |
$1,326.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$398.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,326.87
|
|
|
SHEARS HARMONIC CVD BLADE 36CM
|
Facility
|
IP
|
$2,653.73
|
|
| Hospital Charge Code |
270662788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$398.06 |
| Max. Negotiated Rate |
$398.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$398.06
|
|
|
SHEARS LCS ULTRACISIONS LAPA
|
Facility
|
IP
|
$10,237.50
|
|
| Hospital Charge Code |
270658428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,535.62 |
| Max. Negotiated Rate |
$1,535.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,535.62
|
|
|
SHEARS LCS ULTRACISIONS LAPA
|
Facility
|
OP
|
$10,237.50
|
|
| Hospital Charge Code |
270658428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,330.88 |
| Max. Negotiated Rate |
$5,118.75 |
| Rate for Payer: Aetna Commercial |
$3,071.25
|
| Rate for Payer: Aetna Medicare Advantage |
$3,071.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,610.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,610.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,610.56
|
| Rate for Payer: Cigna Commercial |
$5,118.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,330.88
|
| Rate for Payer: Oxford Commercial |
$5,118.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,535.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,118.75
|
|
|
SHEARS MEDICUT SCISSORS 320-10
|
Facility
|
IP
|
$52.00
|
|
| Hospital Charge Code |
270610065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
SHEARS MEDICUT SCISSORS 320-10
|
Facility
|
OP
|
$52.00
|
|
| Hospital Charge Code |
270610065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$26.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.00
|
|
|
SHEARS MINI 2MM 171305
|
Facility
|
IP
|
$496.85
|
|
| Hospital Charge Code |
270612741
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.53 |
| Max. Negotiated Rate |
$74.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.53
|
|
|
SHEARS MINI 2MM 171305
|
Facility
|
OP
|
$496.85
|
|
| Hospital Charge Code |
270612741
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.59 |
| Max. Negotiated Rate |
$248.43 |
| Rate for Payer: Aetna Commercial |
$149.06
|
| Rate for Payer: Aetna Medicare Advantage |
$149.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.70
|
| Rate for Payer: Cigna Commercial |
$248.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.59
|
| Rate for Payer: Oxford Commercial |
$248.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$248.43
|
|
|
SHEARS PISTOL GRIP 5MM LCSK5
|
Facility
|
OP
|
$2,491.25
|
|
| Hospital Charge Code |
270610040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$323.86 |
| Max. Negotiated Rate |
$1,245.62 |
| Rate for Payer: Aetna Commercial |
$747.38
|
| Rate for Payer: Aetna Medicare Advantage |
$747.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$635.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$635.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$635.27
|
| Rate for Payer: Cigna Commercial |
$1,245.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$323.86
|
| Rate for Payer: Oxford Commercial |
$1,245.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$373.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,245.62
|
|
|
SHEARS PISTOL GRIP 5MM LCSK5
|
Facility
|
IP
|
$2,491.25
|
|
| Hospital Charge Code |
270610040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$373.69 |
| Max. Negotiated Rate |
$373.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$373.69
|
|
|
SHEATH 10FR 30cm
|
Facility
|
IP
|
$380.00
|
|
| Hospital Charge Code |
270634843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.00 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.00
|
|
|
SHEATH 10FR 30cm
|
Facility
|
OP
|
$380.00
|
|
| Hospital Charge Code |
270634843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$114.00
|
| Rate for Payer: Aetna Medicare Advantage |
$114.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$96.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$96.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$96.90
|
| Rate for Payer: Cigna Commercial |
$190.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.40
|
| Rate for Payer: Oxford Commercial |
$190.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.00
|
|
|
SHEATH 12FR PG123000
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270635531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SHEATH 12FR PG123000
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270635531
|
|
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
|
|