|
SUTURE CHROMIC GUT 2-0 V-20
|
Facility
|
OP
|
$13.65
|
|
| Hospital Charge Code |
270655683
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.77 |
| Max. Negotiated Rate |
$6.83 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.48
|
| Rate for Payer: Cigna Commercial |
$6.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.77
|
| Rate for Payer: Oxford Commercial |
$6.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.83
|
|
|
SUTURE CHROMIC GUT 2-0 V-20
|
Facility
|
IP
|
$13.65
|
|
| Hospital Charge Code |
270655683
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
|
|
SUTURE CHROMIC GUT 2-0 V-26
|
Facility
|
IP
|
$16.03
|
|
| Hospital Charge Code |
270655750
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.40
|
|
|
SUTURE CHROMIC GUT 2-0 V-26
|
Facility
|
OP
|
$16.03
|
|
| Hospital Charge Code |
270655750
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$8.02 |
| Rate for Payer: Aetna Commercial |
$4.81
|
| Rate for Payer: Aetna Medicare Advantage |
$4.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.09
|
| Rate for Payer: Cigna Commercial |
$8.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.08
|
| Rate for Payer: Oxford Commercial |
$8.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.02
|
|
|
SUTURE CHROMIC GUT 2 CT-1
|
Facility
|
IP
|
$15.89
|
|
| Hospital Charge Code |
270659061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.38
|
|
|
SUTURE CHROMIC GUT 2 CT-1
|
Facility
|
OP
|
$15.89
|
|
| Hospital Charge Code |
270659061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$7.95 |
| Rate for Payer: Aetna Commercial |
$4.77
|
| Rate for Payer: Aetna Medicare Advantage |
$4.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.05
|
| Rate for Payer: Cigna Commercial |
$7.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.07
|
| Rate for Payer: Oxford Commercial |
$7.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.95
|
|
|
SUTURE CHROMIC GUT 3/0 30 C13
|
Facility
|
IP
|
$7.75
|
|
| Hospital Charge Code |
270604722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
|
|
SUTURE CHROMIC GUT 3/0 30 C13
|
Facility
|
OP
|
$7.75
|
|
| Hospital Charge Code |
270604722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: Aetna Commercial |
$2.33
|
| Rate for Payer: Aetna Medicare Advantage |
$2.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.98
|
| Rate for Payer: Cigna Commercial |
$3.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.01
|
| Rate for Payer: Oxford Commercial |
$3.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.88
|
|
|
SUTURE CHROMIC GUT 3/0 30 CP2
|
Facility
|
IP
|
$6.99
|
|
| Hospital Charge Code |
270675605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
SUTURE CHROMIC GUT 3/0 30 CP2
|
Facility
|
OP
|
$6.99
|
|
| Hospital Charge Code |
270675605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.91
|
| Rate for Payer: Oxford Commercial |
$3.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.50
|
|
|
SUTURE CHROMIC GUT 3/0 30 P12
|
Facility
|
OP
|
$14.94
|
|
| Hospital Charge Code |
270651287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$7.47 |
| 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 |
$3.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.81
|
| Rate for Payer: Cigna Commercial |
$7.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.94
|
| Rate for Payer: Oxford Commercial |
$7.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.47
|
|
|
SUTURE CHROMIC GUT 3/0 30 P12
|
Facility
|
IP
|
$14.94
|
|
| Hospital Charge Code |
270651287
|
|
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 3-0 CT-1
|
Facility
|
OP
|
$15.65
|
|
| Hospital Charge Code |
270655656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$7.83 |
| Rate for Payer: Aetna Commercial |
$4.70
|
| Rate for Payer: Aetna Medicare Advantage |
$4.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.99
|
| Rate for Payer: Cigna Commercial |
$7.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.03
|
| Rate for Payer: Oxford Commercial |
$7.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.83
|
|
|
SUTURE CHROMIC GUT 3-0 CT-1
|
Facility
|
IP
|
$15.65
|
|
| Hospital Charge Code |
270655656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$2.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.35
|
|
|
SUTURE CHROMIC GUT 3-0 FS-2
|
Facility
|
OP
|
$15.01
|
|
| Hospital Charge Code |
270671391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.83
|
| Rate for Payer: Cigna Commercial |
$7.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.95
|
| Rate for Payer: Oxford Commercial |
$7.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.50
|
|
|
SUTURE CHROMIC GUT 3-0 FS-2
|
Facility
|
IP
|
$15.01
|
|
| Hospital Charge Code |
270671391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
|
|
SUTURE CHROMIC GUT 3-0 PS-2
|
Facility
|
IP
|
$47.93
|
|
| Hospital Charge Code |
270655626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$7.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.19
|
|
|
SUTURE CHROMIC GUT 3-0 PS-2
|
Facility
|
OP
|
$47.93
|
|
| Hospital Charge Code |
270655626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$23.96 |
| Rate for Payer: Aetna Commercial |
$14.38
|
| Rate for Payer: Aetna Medicare Advantage |
$14.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.22
|
| Rate for Payer: Cigna Commercial |
$23.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.23
|
| Rate for Payer: Oxford Commercial |
$23.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.96
|
|
|
SUTURE CHROMIC GUT 3-0 RB-1
|
Facility
|
IP
|
$16.62
|
|
| Hospital Charge Code |
270671514
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.49 |
| Max. Negotiated Rate |
$2.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.49
|
|
|
SUTURE CHROMIC GUT 3-0 RB-1
|
Facility
|
OP
|
$16.62
|
|
| Hospital Charge Code |
270671514
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$8.31 |
| Rate for Payer: Aetna Commercial |
$4.99
|
| Rate for Payer: Aetna Medicare Advantage |
$4.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.24
|
| Rate for Payer: Cigna Commercial |
$8.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.16
|
| Rate for Payer: Oxford Commercial |
$8.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.31
|
|
|
SUTURE CHROMIC GUT 3-0 TIES
|
Facility
|
IP
|
$15.74
|
|
| Hospital Charge Code |
270659079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$2.36 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.36
|
|
|
SUTURE CHROMIC GUT 3-0 TIES
|
Facility
|
OP
|
$15.74
|
|
| Hospital Charge Code |
270659079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$7.87 |
| Rate for Payer: Aetna Commercial |
$4.72
|
| Rate for Payer: Aetna Medicare Advantage |
$4.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.01
|
| Rate for Payer: Cigna Commercial |
$7.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.05
|
| Rate for Payer: Oxford Commercial |
$7.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.87
|
|
|
SUTURE CHROMIC GUT 3-0 V-20
|
Facility
|
OP
|
$13.86
|
|
| Hospital Charge Code |
270648403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$6.93 |
| Rate for Payer: Aetna Commercial |
$4.16
|
| Rate for Payer: Aetna Medicare Advantage |
$4.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.53
|
| Rate for Payer: Cigna Commercial |
$6.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.80
|
| Rate for Payer: Oxford Commercial |
$6.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.93
|
|
|
SUTURE CHROMIC GUT 3-0 V-20
|
Facility
|
IP
|
$13.86
|
|
| Hospital Charge Code |
270648403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$2.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.08
|
|
|
SUTURE CHROMIC GUT 3-0 V-26
|
Facility
|
IP
|
$16.21
|
|
| Hospital Charge Code |
270658813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$2.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.43
|
|