|
SUTURE SOFSILK 3/0 18 BLACK
|
Facility
|
IP
|
$13.87
|
|
| Hospital Charge Code |
270604601
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$2.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.08
|
|
|
SUTURE SOFSILK 3/0 18 BLACK
|
Facility
|
OP
|
$13.87
|
|
| Hospital Charge Code |
270604601
|
|
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 |
$3.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.54
|
| 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 SOFSILK 3/0 30 BLACK
|
Facility
|
IP
|
$5.65
|
|
| Hospital Charge Code |
270656170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
|
|
SUTURE SOFSILK 3/0 30 BLACK
|
Facility
|
OP
|
$5.65
|
|
| Hospital Charge Code |
270656170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$1.70
|
| Rate for Payer: Aetna Medicare Advantage |
$1.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.44
|
| Rate for Payer: Cigna Commercial |
$2.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.73
|
| Rate for Payer: Oxford Commercial |
$2.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.83
|
|
|
SUTURE SOFSILK 3/0 30 BLK V20
|
Facility
|
IP
|
$23.97
|
|
| Hospital Charge Code |
270604603
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.60
|
|
|
SUTURE SOFSILK 3/0 30 BLK V20
|
Facility
|
OP
|
$23.97
|
|
| Hospital Charge Code |
270604603
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$11.98 |
| Rate for Payer: Aetna Commercial |
$7.19
|
| Rate for Payer: Aetna Medicare Advantage |
$7.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.11
|
| Rate for Payer: Cigna Commercial |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.12
|
| Rate for Payer: Oxford Commercial |
$11.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.98
|
|
|
SUTURE SOFSILK 3/0 5x18 V20
|
Facility
|
OP
|
$20.30
|
|
| Hospital Charge Code |
270656137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$10.15 |
| Rate for Payer: Aetna Commercial |
$6.09
|
| Rate for Payer: Aetna Medicare Advantage |
$6.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.18
|
| Rate for Payer: Cigna Commercial |
$10.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.64
|
| Rate for Payer: Oxford Commercial |
$10.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.15
|
|
|
SUTURE SOFSILK 3/0 5x18 V20
|
Facility
|
IP
|
$20.30
|
|
| Hospital Charge Code |
270656137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$3.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
|
|
SUTURE SOFSILK 3/0 5x30 V20
|
Facility
|
IP
|
$19.89
|
|
| Hospital Charge Code |
270604602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.98
|
|
|
SUTURE SOFSILK 3/0 5x30 V20
|
Facility
|
OP
|
$19.89
|
|
| Hospital Charge Code |
270604602
|
|
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
|
|
|
SUTURE SOFSILK 3-0 98 REEL
|
Facility
|
IP
|
$4.28
|
|
| Hospital Charge Code |
270651161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.64
|
|
|
SUTURE SOFSILK 3-0 98 REEL
|
Facility
|
OP
|
$4.28
|
|
| Hospital Charge Code |
270651161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$2.14 |
| Rate for Payer: Aetna Commercial |
$1.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.09
|
| Rate for Payer: Cigna Commercial |
$2.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.56
|
| Rate for Payer: Oxford Commercial |
$2.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.14
|
|
|
SUTURE SOFSILK 3-0 BK 12x24
|
Facility
|
OP
|
$6.03
|
|
| Hospital Charge Code |
270651110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna Commercial |
$1.81
|
| Rate for Payer: Aetna Medicare Advantage |
$1.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.54
|
| Rate for Payer: Cigna Commercial |
$3.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.78
|
| Rate for Payer: Oxford Commercial |
$3.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.02
|
|
|
SUTURE SOFSILK 3-0 BK 12x24
|
Facility
|
IP
|
$6.03
|
|
| Hospital Charge Code |
270651110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
SUTURE SOFSILK 3.0 BLACK 18
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
270656165
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.80
|
|
|
SUTURE SOFSILK 3.0 BLACK 18
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
270656165
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.06
|
| Rate for Payer: Cigna Commercial |
$6.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.56
|
| Rate for Payer: Oxford Commercial |
$6.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.00
|
|
|
SUTURE SOFSILK 3-0 BLK 12X30
|
Facility
|
IP
|
$4.79
|
|
| Hospital Charge Code |
270651121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$0.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.72
|
|
|
SUTURE SOFSILK 3-0 BLK 12X30
|
Facility
|
OP
|
$4.79
|
|
| Hospital Charge Code |
270651121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Aetna Commercial |
$1.44
|
| Rate for Payer: Aetna Medicare Advantage |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.22
|
| Rate for Payer: Cigna Commercial |
$2.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.62
|
| Rate for Payer: Oxford Commercial |
$2.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.40
|
|
|
SUTURE SOFSILK 3-0 NDL SS684
|
Facility
|
IP
|
$6.65
|
|
| Hospital Charge Code |
270634718
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
|
|
SUTURE SOFSILK 3-0 NDL SS684
|
Facility
|
OP
|
$6.65
|
|
| Hospital Charge Code |
270634718
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$3.33 |
| Rate for Payer: Aetna Commercial |
$2.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.70
|
| Rate for Payer: Cigna Commercial |
$3.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.86
|
| Rate for Payer: Oxford Commercial |
$3.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.33
|
|
|
SUTURE SOFSILK 4/0 12x24 BLK
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
270604595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
SUTURE SOFSILK 4/0 12x24 BLK
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
270604595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.78 |
| 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 |
$0.78
|
| Rate for Payer: Oxford Commercial |
$2.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.98
|
|
|
SUTURE SOFSILK 4/0 12x30 BLK
|
Facility
|
IP
|
$7.80
|
|
| Hospital Charge Code |
270608847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$1.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.17
|
|
|
SUTURE SOFSILK 4/0 12x30 BLK
|
Facility
|
OP
|
$7.80
|
|
| Hospital Charge Code |
270608847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: Aetna Medicare Advantage |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.99
|
| Rate for Payer: Cigna Commercial |
$3.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.01
|
| Rate for Payer: Oxford Commercial |
$3.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.90
|
|
|
SUTURE SOFSILK 4/0 18 BLACK
|
Facility
|
OP
|
$13.46
|
|
| Hospital Charge Code |
270604606
|
|
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
|
|