|
STAPLER POWER 25MM
|
Facility
|
IP
|
$2,145.00
|
|
| Hospital Charge Code |
270687760
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.75 |
| Max. Negotiated Rate |
$321.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.75
|
|
|
STAPLER POWER 25MM
|
Facility
|
OP
|
$2,145.00
|
|
| Hospital Charge Code |
270687760
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$278.85 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$643.50
|
| Rate for Payer: Aetna Medicare Advantage |
$643.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$546.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$546.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$546.98
|
| Rate for Payer: Cigna Commercial |
$1,072.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$278.85
|
| Rate for Payer: Oxford Commercial |
$1,072.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,072.50
|
|
|
STAPLER POWER 31MM
|
Facility
|
OP
|
$2,145.00
|
|
| Hospital Charge Code |
270687761
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$278.85 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$643.50
|
| Rate for Payer: Aetna Medicare Advantage |
$643.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$546.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$546.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$546.98
|
| Rate for Payer: Cigna Commercial |
$1,072.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$278.85
|
| Rate for Payer: Oxford Commercial |
$1,072.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,072.50
|
|
|
STAPLER POWER 31MM
|
Facility
|
IP
|
$2,145.00
|
|
| Hospital Charge Code |
270687761
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.75 |
| Max. Negotiated Rate |
$321.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.75
|
|
|
STAPLER POWERED LDS 15W DISP
|
Facility
|
OP
|
$2,468.36
|
|
| Hospital Charge Code |
270600145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$320.89 |
| Max. Negotiated Rate |
$1,234.18 |
| Rate for Payer: Aetna Commercial |
$740.51
|
| Rate for Payer: Aetna Medicare Advantage |
$740.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$629.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$629.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$629.43
|
| Rate for Payer: Cigna Commercial |
$1,234.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$320.89
|
| Rate for Payer: Oxford Commercial |
$1,234.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$370.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,234.18
|
|
|
STAPLER POWERED LDS 15W DISP
|
Facility
|
IP
|
$2,468.36
|
|
| Hospital Charge Code |
270600145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$370.25 |
| Max. Negotiated Rate |
$370.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$370.25
|
|
|
STAPLER PROXIMATE DISP 35 WIDE
|
Facility
|
IP
|
$60.90
|
|
| Hospital Charge Code |
270656000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$9.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.13
|
|
|
STAPLER PROXIMATE DISP 35 WIDE
|
Facility
|
OP
|
$60.90
|
|
| Hospital Charge Code |
270656000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$30.45 |
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Medicare Advantage |
$18.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.53
|
| Rate for Payer: Cigna Commercial |
$30.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.92
|
| Rate for Payer: Oxford Commercial |
$30.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.45
|
|
|
STAPLER PROXIMATE SKIN REG 35
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
270671550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
|
|
STAPLER PROXIMATE SKIN REG 35
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
270671550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$12.50 |
| Rate for Payer: Aetna Commercial |
$7.50
|
| Rate for Payer: Aetna Medicare Advantage |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.38
|
| Rate for Payer: Cigna Commercial |
$12.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.25
|
| Rate for Payer: Oxford Commercial |
$12.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.50
|
|
|
STAPLER PROXIMATE SKIN WIDE 35
|
Facility
|
IP
|
$30.96
|
|
| Hospital Charge Code |
270671551S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.64
|
|
|
STAPLER PROXIMATE SKIN WIDE 35
|
Facility
|
IP
|
$35.00
|
|
| Hospital Charge Code |
270671551N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.25
|
|
|
STAPLER PROXIMATE SKIN WIDE 35
|
Facility
|
IP
|
$30.96
|
|
| Hospital Charge Code |
270671551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.64
|
|
|
STAPLER PROXIMATE SKIN WIDE 35
|
Facility
|
OP
|
$30.96
|
|
| Hospital Charge Code |
270671551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$15.48 |
| Rate for Payer: Aetna Commercial |
$9.29
|
| Rate for Payer: Aetna Medicare Advantage |
$9.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.89
|
| Rate for Payer: Cigna Commercial |
$15.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.02
|
| Rate for Payer: Oxford Commercial |
$15.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.48
|
|
|
STAPLER PROXIMATE SKIN WIDE 35
|
Facility
|
OP
|
$30.96
|
|
| Hospital Charge Code |
270671551S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$15.48 |
| Rate for Payer: Aetna Commercial |
$9.29
|
| Rate for Payer: Aetna Medicare Advantage |
$9.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.89
|
| Rate for Payer: Cigna Commercial |
$15.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.02
|
| Rate for Payer: Oxford Commercial |
$15.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.48
|
|
|
STAPLER PROXIMATE SKIN WIDE 35
|
Facility
|
OP
|
$35.00
|
|
| Hospital Charge Code |
270671551N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Aetna Commercial |
$10.50
|
| Rate for Payer: Aetna Medicare Advantage |
$10.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.93
|
| Rate for Payer: Cigna Commercial |
$17.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.55
|
| Rate for Payer: Oxford Commercial |
$17.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.50
|
|
|
STAPLER PURSTRING 65 INST
|
Facility
|
IP
|
$837.47
|
|
| Hospital Charge Code |
270600130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.62 |
| Max. Negotiated Rate |
$125.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.62
|
|
|
STAPLER PURSTRING 65 INST
|
Facility
|
OP
|
$837.47
|
|
| Hospital Charge Code |
270600130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.87 |
| Max. Negotiated Rate |
$418.74 |
| Rate for Payer: Aetna Commercial |
$251.24
|
| Rate for Payer: Aetna Medicare Advantage |
$251.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$213.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$213.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$213.55
|
| Rate for Payer: Cigna Commercial |
$418.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$108.87
|
| Rate for Payer: Oxford Commercial |
$418.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$418.74
|
|
|
STAPLER RELOAD
|
Facility
|
OP
|
$413.92
|
|
| Hospital Charge Code |
270667075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.81 |
| Max. Negotiated Rate |
$206.96 |
| Rate for Payer: Aetna Commercial |
$124.18
|
| Rate for Payer: Aetna Medicare Advantage |
$124.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.55
|
| Rate for Payer: Cigna Commercial |
$206.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.81
|
| Rate for Payer: Oxford Commercial |
$206.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$206.96
|
|
|
STAPLER RELOAD
|
Facility
|
IP
|
$413.92
|
|
| Hospital Charge Code |
270667075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.09 |
| Max. Negotiated Rate |
$62.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.09
|
|
|
STAPLER RELOAD 60 MM BLACK
|
Facility
|
OP
|
$3,943.32
|
|
| Hospital Charge Code |
270691805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$512.63 |
| Max. Negotiated Rate |
$1,971.66 |
| Rate for Payer: Aetna Commercial |
$1,183.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,183.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,005.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,005.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,005.55
|
| Rate for Payer: Cigna Commercial |
$1,971.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$512.63
|
| Rate for Payer: Oxford Commercial |
$1,971.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$591.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,971.66
|
|
|
STAPLER RELOAD 60 MM BLACK
|
Facility
|
IP
|
$3,943.32
|
|
| Hospital Charge Code |
270691805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$591.50 |
| Max. Negotiated Rate |
$591.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$591.50
|
|
|
STAPLER RELOADABLE LINEAR 30MM
|
Facility
|
IP
|
$454.00
|
|
| Hospital Charge Code |
270334721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.10 |
| Max. Negotiated Rate |
$68.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.10
|
|
|
STAPLER RELOADABLE LINEAR 30MM
|
Facility
|
OP
|
$454.00
|
|
| Hospital Charge Code |
270334721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.02 |
| Max. Negotiated Rate |
$227.00 |
| Rate for Payer: Aetna Commercial |
$136.20
|
| Rate for Payer: Aetna Medicare Advantage |
$136.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$115.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$115.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$115.77
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.02
|
| Rate for Payer: Oxford Commercial |
$227.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$227.00
|
|
|
STAPLER RELOADABLE SIG TA3035S
|
Facility
|
IP
|
$443.15
|
|
| Hospital Charge Code |
270630377
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.47 |
| Max. Negotiated Rate |
$66.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.47
|
|
