|
SUTURE CHROMIC GUT 1 GS-24
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
270659060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$12.88 |
| Rate for Payer: Aetna Commercial |
$7.72
|
| Rate for Payer: Aetna Medicare Advantage |
$7.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.57
|
| Rate for Payer: Cigna Commercial |
$12.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.35
|
| Rate for Payer: Oxford Commercial |
$12.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.88
|
|
|
SUTURE CHROMIC GUT 1 GS-25
|
Facility
|
OP
|
$27.58
|
|
| Hospital Charge Code |
270655672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$13.79 |
| Rate for Payer: Aetna Commercial |
$8.27
|
| Rate for Payer: Aetna Medicare Advantage |
$8.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.03
|
| Rate for Payer: Cigna Commercial |
$13.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.59
|
| Rate for Payer: Oxford Commercial |
$13.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.79
|
|
|
SUTURE CHROMIC GUT 1 GS-25
|
Facility
|
IP
|
$27.58
|
|
| Hospital Charge Code |
270655672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$4.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.14
|
|
|
SUTURE CHROMIC GUT 1 TIES
|
Facility
|
OP
|
$15.15
|
|
| Hospital Charge Code |
270671499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$7.58 |
| Rate for Payer: Aetna Commercial |
$4.54
|
| Rate for Payer: Aetna Medicare Advantage |
$4.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.86
|
| Rate for Payer: Cigna Commercial |
$7.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.97
|
| Rate for Payer: Oxford Commercial |
$7.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.58
|
|
|
SUTURE CHROMIC GUT 1 TIES
|
Facility
|
IP
|
$15.15
|
|
| Hospital Charge Code |
270671499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$2.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.27
|
|
|
SUTURE CHROMIC GUT 2/0 30
|
Facility
|
OP
|
$8.67
|
|
| Hospital Charge Code |
270613635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.33 |
| Rate for Payer: Aetna Commercial |
$2.60
|
| Rate for Payer: Aetna Medicare Advantage |
$2.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.21
|
| Rate for Payer: Cigna Commercial |
$4.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.13
|
| Rate for Payer: Oxford Commercial |
$4.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.33
|
|
|
SUTURE CHROMIC GUT 2/0 30
|
Facility
|
IP
|
$8.67
|
|
| Hospital Charge Code |
270613635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.30
|
|
|
SUTURE CHROMIC GUT 2/0 30 CT1
|
Facility
|
OP
|
$6.73
|
|
| Hospital Charge Code |
270651491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.37 |
| Rate for Payer: Aetna Commercial |
$2.02
|
| Rate for Payer: Aetna Medicare Advantage |
$2.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.72
|
| Rate for Payer: Cigna Commercial |
$3.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.87
|
| Rate for Payer: Oxford Commercial |
$3.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.37
|
|
|
SUTURE CHROMIC GUT 2/0 30 CT1
|
Facility
|
IP
|
$6.73
|
|
| Hospital Charge Code |
270651491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$1.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.01
|
|
|
SUTURE CHROMIC GUT 2/0 30 GS24
|
Facility
|
OP
|
$6.78
|
|
| Hospital Charge Code |
270651794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.39 |
| Rate for Payer: Aetna Commercial |
$2.03
|
| Rate for Payer: Aetna Medicare Advantage |
$2.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.73
|
| Rate for Payer: Cigna Commercial |
$3.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.88
|
| Rate for Payer: Oxford Commercial |
$3.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.39
|
|
|
SUTURE CHROMIC GUT 2/0 30 GS24
|
Facility
|
IP
|
$6.78
|
|
| Hospital Charge Code |
270651794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.02
|
|
|
SUTURE CHROMIC GUT 2/0 36 CT1
|
Facility
|
IP
|
$7.39
|
|
| Hospital Charge Code |
270600557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$1.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.11
|
|
|
SUTURE CHROMIC GUT 2/0 36 CT1
|
Facility
|
OP
|
$7.39
|
|
| Hospital Charge Code |
270600557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$3.69 |
| Rate for Payer: Aetna Commercial |
$2.22
|
| Rate for Payer: Aetna Medicare Advantage |
$2.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.88
|
| Rate for Payer: Cigna Commercial |
$3.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.96
|
| Rate for Payer: Oxford Commercial |
$3.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.69
|
|
|
SUTURE CHROMIC GUT 2/0 36 IN
|
Facility
|
IP
|
$6.78
|
|
| Hospital Charge Code |
270659481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.02
|
|
|
SUTURE CHROMIC GUT 2/0 36 IN
|
Facility
|
OP
|
$6.78
|
|
| Hospital Charge Code |
270659481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.39 |
| Rate for Payer: Aetna Commercial |
$2.03
|
| Rate for Payer: Aetna Medicare Advantage |
$2.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.73
|
| Rate for Payer: Cigna Commercial |
$3.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.88
|
| Rate for Payer: Oxford Commercial |
$3.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.39
|
|
|
SUTURE CHROMIC GUT 2-0 CT-1
|
Facility
|
OP
|
$14.92
|
|
| Hospital Charge Code |
270671429
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$7.46 |
| Rate for Payer: Aetna Commercial |
$4.48
|
| Rate for Payer: Aetna Medicare Advantage |
$4.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.80
|
| Rate for Payer: Cigna Commercial |
$7.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.94
|
| Rate for Payer: Oxford Commercial |
$7.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.46
|
|
|
SUTURE CHROMIC GUT 2-0 CT-1
|
Facility
|
OP
|
$13.46
|
|
| Hospital Charge Code |
270655661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$6.73 |
| Rate for Payer: Aetna Commercial |
$4.04
|
| Rate for Payer: Aetna Medicare Advantage |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.43
|
| Rate for Payer: Cigna Commercial |
$6.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.75
|
| Rate for Payer: Oxford Commercial |
$6.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.73
|
|
|
SUTURE CHROMIC GUT 2-0 CT-1
|
Facility
|
IP
|
$13.46
|
|
| Hospital Charge Code |
270655661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.02
|
|
|
SUTURE CHROMIC GUT 2-0 CT-1
|
Facility
|
IP
|
$14.92
|
|
| Hospital Charge Code |
270671429
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.24
|
|
|
SUTURE CHROMIC GUT 2-0 TIES
|
Facility
|
IP
|
$16.23
|
|
| Hospital Charge Code |
270655704
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$2.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.43
|
|
|
SUTURE CHROMIC GUT 2-0 TIES
|
Facility
|
OP
|
$15.62
|
|
| Hospital Charge Code |
270671497
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$7.81 |
| Rate for Payer: Aetna Commercial |
$4.69
|
| Rate for Payer: Aetna Medicare Advantage |
$4.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.98
|
| Rate for Payer: Cigna Commercial |
$7.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.03
|
| Rate for Payer: Oxford Commercial |
$7.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.81
|
|
|
SUTURE CHROMIC GUT 2-0 TIES
|
Facility
|
IP
|
$15.62
|
|
| Hospital Charge Code |
270671497
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$2.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.34
|
|
|
SUTURE CHROMIC GUT 2-0 TIES
|
Facility
|
OP
|
$16.23
|
|
| Hospital Charge Code |
270655704
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$8.12 |
| Rate for Payer: Aetna Commercial |
$4.87
|
| Rate for Payer: Aetna Medicare Advantage |
$4.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.14
|
| Rate for Payer: Cigna Commercial |
$8.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.11
|
| Rate for Payer: Oxford Commercial |
$8.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.12
|
|
|
SUTURE CHROMIC GUT 2-0 UR-5
|
Facility
|
IP
|
$19.89
|
|
| Hospital Charge Code |
270671515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.98
|
|
|
SUTURE CHROMIC GUT 2-0 UR-5
|
Facility
|
OP
|
$19.89
|
|
| Hospital Charge Code |
270671515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$9.95 |
| Rate for Payer: Aetna Commercial |
$5.97
|
| Rate for Payer: Aetna Medicare Advantage |
$5.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.07
|
| Rate for Payer: Cigna Commercial |
$9.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$9.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.95
|
|