|
SUTURE MONOCRYL 3-0 CT-1
|
Facility
|
IP
|
$11.79
|
|
| Hospital Charge Code |
270672888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.77 |
| Max. Negotiated Rate |
$1.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.77
|
|
|
SUTURE MONOCRYL 3-0 CV-25
|
Facility
|
IP
|
$10.64
|
|
| Hospital Charge Code |
270672365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.60
|
|
|
SUTURE MONOCRYL 3-0 CV-25
|
Facility
|
OP
|
$10.64
|
|
| Hospital Charge Code |
270672365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$5.32 |
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: Aetna Medicare Advantage |
$3.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.71
|
| Rate for Payer: Cigna Commercial |
$5.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.38
|
| Rate for Payer: Oxford Commercial |
$5.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.32
|
|
|
SUTURE MONOCRYL 3-0 KS
|
Facility
|
OP
|
$13.48
|
|
| Hospital Charge Code |
270671527
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$6.74 |
| 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 |
$3.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.44
|
| Rate for Payer: Cigna Commercial |
$6.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.75
|
| Rate for Payer: Oxford Commercial |
$6.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.74
|
|
|
SUTURE MONOCRYL 3-0 KS
|
Facility
|
IP
|
$13.48
|
|
| Hospital Charge Code |
270671527
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.02
|
|
|
SUTURE MONOCRYL 3-0 PS-1
|
Facility
|
OP
|
$28.53
|
|
| Hospital Charge Code |
270661966
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$14.27 |
| Rate for Payer: Aetna Commercial |
$8.56
|
| Rate for Payer: Aetna Medicare Advantage |
$8.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.28
|
| Rate for Payer: Cigna Commercial |
$14.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.71
|
| Rate for Payer: Oxford Commercial |
$14.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.27
|
|
|
SUTURE MONOCRYL 3-0 PS-1
|
Facility
|
IP
|
$28.53
|
|
| Hospital Charge Code |
270661966
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.28 |
| Max. Negotiated Rate |
$4.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.28
|
|
|
SUTURE MONOCRYL 3-0 PS-2
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
270671526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
|
|
SUTURE MONOCRYL 3-0 PS-2
|
Facility
|
OP
|
$26.73
|
|
| Hospital Charge Code |
270671523
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$8.02
|
| Rate for Payer: Aetna Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.82
|
| Rate for Payer: Cigna Commercial |
$13.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.47
|
| Rate for Payer: Oxford Commercial |
$13.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.37
|
|
|
SUTURE MONOCRYL 3-0 PS-2
|
Facility
|
IP
|
$26.73
|
|
| Hospital Charge Code |
270671523
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$4.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.01
|
|
|
SUTURE MONOCRYL 3-0 PS-2
|
Facility
|
OP
|
$26.22
|
|
| Hospital Charge Code |
270671750
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: UnitedHealthcare Commercial |
$13.11
|
| Rate for Payer: Aetna Commercial |
$7.87
|
| Rate for Payer: Aetna Medicare Advantage |
$7.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.69
|
| Rate for Payer: Cigna Commercial |
$13.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.41
|
| Rate for Payer: Oxford Commercial |
$13.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.93
|
|
|
SUTURE MONOCRYL 3-0 PS-2
|
Facility
|
IP
|
$26.22
|
|
| Hospital Charge Code |
270671750
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$3.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.93
|
|
|
SUTURE MONOCRYL 3-0 PS-2
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
270671526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$13.01 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare Advantage |
$7.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.63
|
| Rate for Payer: Cigna Commercial |
$13.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.38
|
| Rate for Payer: Oxford Commercial |
$13.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.01
|
|
|
SUTURE MONOCRYL 3-0 SH
|
Facility
|
IP
|
$9.85
|
|
| Hospital Charge Code |
270673260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$1.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.48
|
|
|
SUTURE MONOCRYL 3-0 SH
|
Facility
|
OP
|
$9.85
|
|
| Hospital Charge Code |
270673260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.28 |
| Max. Negotiated Rate |
$4.92 |
| Rate for Payer: Aetna Commercial |
$2.96
|
| Rate for Payer: Aetna Medicare Advantage |
$2.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.51
|
| Rate for Payer: Cigna Commercial |
$4.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.28
|
| Rate for Payer: Oxford Commercial |
$4.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.92
|
|
|
SUTURE MONOCRYL 3-0 SH
|
Facility
|
IP
|
$10.04
|
|
| Hospital Charge Code |
270671521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.51
|
|
|
SUTURE MONOCRYL 3-0 SH
|
Facility
|
OP
|
$10.04
|
|
| Hospital Charge Code |
270671521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Aetna Commercial |
$3.01
|
| Rate for Payer: Aetna Medicare Advantage |
$3.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.56
|
| Rate for Payer: Cigna Commercial |
$5.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.31
|
| Rate for Payer: Oxford Commercial |
$5.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.02
|
|
|
SUTURE MONOCRYL 3-1 PS-2
|
Facility
|
OP
|
$26.10
|
|
| Hospital Charge Code |
270672366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$13.05 |
| Rate for Payer: Aetna Commercial |
$7.83
|
| Rate for Payer: Aetna Medicare Advantage |
$7.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.66
|
| Rate for Payer: Cigna Commercial |
$13.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.39
|
| Rate for Payer: Oxford Commercial |
$13.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.05
|
|
|
SUTURE MONOCRYL 3-1 PS-2
|
Facility
|
IP
|
$26.10
|
|
| Hospital Charge Code |
270672366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.92 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.92
|
|
|
SUTURE MONOCRYL 4-0 P-3
|
Facility
|
IP
|
$28.09
|
|
| Hospital Charge Code |
270671525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$4.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.21
|
|
|
SUTURE MONOCRYL 4-0 P-3
|
Facility
|
OP
|
$28.09
|
|
| Hospital Charge Code |
270671525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$14.04 |
| Rate for Payer: Aetna Commercial |
$8.43
|
| Rate for Payer: Aetna Medicare Advantage |
$8.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.16
|
| Rate for Payer: Cigna Commercial |
$14.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.65
|
| Rate for Payer: Oxford Commercial |
$14.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.04
|
|
|
SUTURE MONOCRYL 4-0 P-3
|
Facility
|
OP
|
$41.66
|
|
| Hospital Charge Code |
270660423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$20.83 |
| Rate for Payer: Aetna Commercial |
$12.50
|
| Rate for Payer: Aetna Medicare Advantage |
$12.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.62
|
| Rate for Payer: Cigna Commercial |
$20.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.42
|
| Rate for Payer: Oxford Commercial |
$20.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.83
|
|
|
SUTURE MONOCRYL 4-0 P-3
|
Facility
|
IP
|
$41.66
|
|
| Hospital Charge Code |
270660423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$6.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.25
|
|
|
SUTURE MONOCRYL 4-0 PC-5
|
Facility
|
OP
|
$26.40
|
|
| Hospital Charge Code |
270662583
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$13.20 |
| Rate for Payer: Aetna Commercial |
$7.92
|
| Rate for Payer: Aetna Medicare Advantage |
$7.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.73
|
| Rate for Payer: Cigna Commercial |
$13.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.43
|
| Rate for Payer: Oxford Commercial |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.20
|
|
|
SUTURE MONOCRYL 4-0 PC-5
|
Facility
|
IP
|
$26.40
|
|
| Hospital Charge Code |
270662583
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.96 |
| Max. Negotiated Rate |
$3.96 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.96
|
|