|
SUTURE SILK 4-0 P-3
|
Facility
|
OP
|
$18.11
|
|
| Hospital Charge Code |
270671393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$9.05 |
| Rate for Payer: Aetna Commercial |
$5.43
|
| Rate for Payer: Aetna Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.62
|
| Rate for Payer: Cigna Commercial |
$9.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.35
|
| Rate for Payer: Oxford Commercial |
$9.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.05
|
|
|
SUTURE SILK 4-0 P-3
|
Facility
|
IP
|
$18.11
|
|
| Hospital Charge Code |
270671393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$2.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.72
|
|
|
SUTURE SILK 4-0 RB-1
|
Facility
|
OP
|
$8.40
|
|
| Hospital Charge Code |
270655867
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Aetna Commercial |
$2.52
|
| Rate for Payer: Aetna Medicare Advantage |
$2.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.14
|
| Rate for Payer: Cigna Commercial |
$4.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.09
|
| Rate for Payer: Oxford Commercial |
$4.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.20
|
|
|
SUTURE SILK 4-0 RB-1
|
Facility
|
IP
|
$8.40
|
|
| Hospital Charge Code |
270655867
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$1.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.26
|
|
|
SUTURE SILK 4-0 SH
|
Facility
|
IP
|
$46.81
|
|
| Hospital Charge Code |
270671439
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$7.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.02
|
|
|
SUTURE SILK 4-0 SH
|
Facility
|
OP
|
$46.81
|
|
| Hospital Charge Code |
270671439
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.09 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$14.04
|
| Rate for Payer: Aetna Medicare Advantage |
$14.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.94
|
| Rate for Payer: Cigna Commercial |
$23.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.09
|
| Rate for Payer: Oxford Commercial |
$23.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.41
|
|
|
SUTURE SILK 4-0 TIES
|
Facility
|
IP
|
$10.89
|
|
| Hospital Charge Code |
270671500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$1.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.63
|
|
|
SUTURE SILK 4-0 TIES
|
Facility
|
OP
|
$21.54
|
|
| Hospital Charge Code |
270671431
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$10.77 |
| Rate for Payer: Aetna Commercial |
$6.46
|
| Rate for Payer: Aetna Medicare Advantage |
$6.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.49
|
| Rate for Payer: Cigna Commercial |
$10.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.80
|
| Rate for Payer: Oxford Commercial |
$10.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.77
|
|
|
SUTURE SILK 4-0 TIES
|
Facility
|
OP
|
$10.89
|
|
| Hospital Charge Code |
270671500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$5.45 |
| Rate for Payer: Aetna Commercial |
$3.27
|
| Rate for Payer: Aetna Medicare Advantage |
$3.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.78
|
| Rate for Payer: Cigna Commercial |
$5.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.42
|
| Rate for Payer: Oxford Commercial |
$5.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.45
|
|
|
SUTURE SILK 4-0 TIES
|
Facility
|
IP
|
$21.54
|
|
| Hospital Charge Code |
270671431
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$3.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.23
|
|
|
SUTURE SILK 4-0 V-20
|
Facility
|
OP
|
$5.96
|
|
| Hospital Charge Code |
270664549
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Aetna Commercial |
$1.79
|
| Rate for Payer: Aetna Medicare Advantage |
$1.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.52
|
| Rate for Payer: Cigna Commercial |
$2.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.77
|
| Rate for Payer: Oxford Commercial |
$2.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.98
|
|
|
SUTURE SILK 4-0 V-20
|
Facility
|
IP
|
$5.96
|
|
| Hospital Charge Code |
270664549
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$0.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.89
|
|
|
SUTURE SILK 5-0 P-3
|
Facility
|
IP
|
$18.66
|
|
| Hospital Charge Code |
270671392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$2.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.80
|
|
|
SUTURE SILK 5-0 P-3
|
Facility
|
OP
|
$18.66
|
|
| Hospital Charge Code |
270671392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$9.33 |
| Rate for Payer: Aetna Commercial |
$5.60
|
| Rate for Payer: Aetna Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.76
|
| Rate for Payer: Cigna Commercial |
$9.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.43
|
| Rate for Payer: Oxford Commercial |
$9.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.33
|
|
|
SUTURE SILK 6-0 BLK BR G-7 18
|
Facility
|
IP
|
$1,464.60
|
|
| Hospital Charge Code |
270662653
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.69 |
| Max. Negotiated Rate |
$219.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.69
|
|
|
SUTURE SILK 6-0 BLK BR G-7 18
|
Facility
|
OP
|
$1,464.60
|
|
| Hospital Charge Code |
270662653
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$732.30 |
| Rate for Payer: Aetna Commercial |
$439.38
|
| Rate for Payer: Aetna Medicare Advantage |
$439.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.47
|
| Rate for Payer: Cigna Commercial |
$732.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$190.40
|
| Rate for Payer: Oxford Commercial |
$732.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$732.30
|
|
|
SUTURE SILK 6-0 G-11
|
Facility
|
OP
|
$23.43
|
|
| Hospital Charge Code |
270655847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.05 |
| Max. Negotiated Rate |
$11.71 |
| Rate for Payer: Aetna Commercial |
$7.03
|
| Rate for Payer: Aetna Medicare Advantage |
$7.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.97
|
| Rate for Payer: Cigna Commercial |
$11.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.05
|
| Rate for Payer: Oxford Commercial |
$11.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.71
|
|
|
SUTURE SILK 6-0 G-11
|
Facility
|
IP
|
$23.43
|
|
| Hospital Charge Code |
270655847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$3.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.51
|
|
|
SUTURE SILK 7-0, 18 INCH
|
Facility
|
IP
|
$499.35
|
|
| Hospital Charge Code |
270657448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.90 |
| Max. Negotiated Rate |
$74.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.90
|
|
|
SUTURE SILK 7-0, 18 INCH
|
Facility
|
OP
|
$499.35
|
|
| Hospital Charge Code |
270657448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$249.68 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: Aetna Medicare Advantage |
$149.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.33
|
| Rate for Payer: Cigna Commercial |
$249.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.92
|
| Rate for Payer: Oxford Commercial |
$249.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$249.68
|
|
|
SUTURE SILK 7-0 BLK BR G-7 18
|
Facility
|
OP
|
$1,477.40
|
|
| Hospital Charge Code |
270662652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.06 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna Commercial |
$443.22
|
| Rate for Payer: Aetna Medicare Advantage |
$443.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.74
|
| Rate for Payer: Cigna Commercial |
$738.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$192.06
|
| Rate for Payer: Oxford Commercial |
$738.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$738.70
|
|
|
SUTURE SILK 7-0 BLK BR G-7 18
|
Facility
|
IP
|
$1,477.40
|
|
| Hospital Charge Code |
270662652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.61 |
| Max. Negotiated Rate |
$221.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.61
|
|
|
SUTURE SILK C3 8-0
|
Facility
|
IP
|
$100.95
|
|
| Hospital Charge Code |
270608746
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.14 |
| Max. Negotiated Rate |
$15.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.14
|
|
|
SUTURE SILK C3 8-0
|
Facility
|
OP
|
$100.95
|
|
| Hospital Charge Code |
270608746
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$50.48 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: Aetna Medicare Advantage |
$30.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.74
|
| Rate for Payer: Cigna Commercial |
$50.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.12
|
| Rate for Payer: Oxford Commercial |
$50.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.48
|
|
|
SUTURE SILK CP1 2-0
|
Facility
|
IP
|
$26.45
|
|
| Hospital Charge Code |
270604597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.97
|
|