|
SUTURE STEEL 2-0 FSLX
|
Facility
|
IP
|
$10.13
|
|
| Hospital Charge Code |
270659092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$1.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.52
|
|
|
SUTURE STEEL 2-0 FSLX
|
Facility
|
OP
|
$10.13
|
|
| Hospital Charge Code |
270659092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$5.07 |
| Rate for Payer: Aetna Commercial |
$3.04
|
| Rate for Payer: Aetna Medicare Advantage |
$3.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.58
|
| Rate for Payer: Cigna Commercial |
$5.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.32
|
| Rate for Payer: Oxford Commercial |
$5.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.07
|
|
|
SUTURE STEEL 5 MONO B&S20 CCS
|
Facility
|
IP
|
$135.45
|
|
| Hospital Charge Code |
270636868
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$20.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.32
|
|
|
SUTURE STEEL 5 MONO B&S20 CCS
|
Facility
|
OP
|
$135.45
|
|
| Hospital Charge Code |
270636868
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$67.72 |
| Rate for Payer: Aetna Commercial |
$40.63
|
| Rate for Payer: Aetna Medicare Advantage |
$40.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.54
|
| Rate for Payer: Cigna Commercial |
$67.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.61
|
| Rate for Payer: Oxford Commercial |
$67.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$67.72
|
|
|
SUTURE STEEL CCS 7 18IN
|
Facility
|
IP
|
$194.67
|
|
| Hospital Charge Code |
270676502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$29.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.20
|
|
|
SUTURE STEEL CCS 7 18IN
|
Facility
|
OP
|
$194.67
|
|
| Hospital Charge Code |
270676502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.31 |
| Max. Negotiated Rate |
$97.33 |
| Rate for Payer: Aetna Commercial |
$58.40
|
| Rate for Payer: Aetna Medicare Advantage |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.64
|
| Rate for Payer: Cigna Commercial |
$97.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.31
|
| Rate for Payer: Oxford Commercial |
$97.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$97.33
|
|
|
SUTURE STEEL NON NEEDLE PRODUC
|
Facility
|
IP
|
$19.16
|
|
| Hospital Charge Code |
270651348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$2.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.87
|
|
|
SUTURE STEEL NON NEEDLE PRODUC
|
Facility
|
OP
|
$19.16
|
|
| Hospital Charge Code |
270651348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.49 |
| Max. Negotiated Rate |
$9.58 |
| Rate for Payer: Aetna Commercial |
$5.75
|
| Rate for Payer: Aetna Medicare Advantage |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.89
|
| Rate for Payer: Cigna Commercial |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.49
|
| Rate for Payer: Oxford Commercial |
$9.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.58
|
|
|
SUTURE STERNOTOMY USP SZ6
|
Facility
|
OP
|
$37.65
|
|
| Hospital Charge Code |
270604715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Aetna Commercial |
$11.29
|
| Rate for Payer: Aetna Medicare Advantage |
$11.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.60
|
| Rate for Payer: Cigna Commercial |
$18.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.89
|
| Rate for Payer: Oxford Commercial |
$18.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.82
|
|
|
SUTURE STERNOTOMY USP SZ6
|
Facility
|
IP
|
$37.65
|
|
| Hospital Charge Code |
270604715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$5.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
|
|
SUTURE STRATA 0 MH
|
Facility
|
IP
|
$75.68
|
|
| Hospital Charge Code |
270671509
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$11.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
|
|
SUTURE STRATA 0 MH
|
Facility
|
OP
|
$75.68
|
|
| Hospital Charge Code |
270671509
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$37.84 |
| Rate for Payer: Aetna Commercial |
$22.70
|
| Rate for Payer: Aetna Medicare Advantage |
$22.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.30
|
| Rate for Payer: Cigna Commercial |
$37.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.84
|
| Rate for Payer: Oxford Commercial |
$37.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.84
|
|
|
SUTURE STRATA 1 CT-1
|
Facility
|
OP
|
$112.61
|
|
| Hospital Charge Code |
270671512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$56.30 |
| Rate for Payer: Aetna Commercial |
$33.78
|
| Rate for Payer: Aetna Medicare Advantage |
$33.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.72
|
| Rate for Payer: Cigna Commercial |
$56.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.64
|
| Rate for Payer: Oxford Commercial |
$56.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.30
|
|
|
SUTURE STRATA 1 CT-1
|
Facility
|
IP
|
$112.61
|
|
| Hospital Charge Code |
270671512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.89 |
| Max. Negotiated Rate |
$16.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.89
|
|
|
SUTURE STRATA 1 CTX
|
Facility
|
IP
|
$104.05
|
|
| Hospital Charge Code |
270673096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.61
|
|
|
SUTURE STRATA 1 CTX
|
Facility
|
OP
|
$104.05
|
|
| Hospital Charge Code |
270673096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare Advantage |
$31.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.53
|
| Rate for Payer: Cigna Commercial |
$52.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.53
|
| Rate for Payer: Oxford Commercial |
$52.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.02
|
|
|
SUTURE STRATA 2-0 CT-1 20CM
|
Facility
|
OP
|
$111.04
|
|
| Hospital Charge Code |
270671506
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.44 |
| Max. Negotiated Rate |
$55.52 |
| Rate for Payer: Aetna Commercial |
$33.31
|
| Rate for Payer: Aetna Medicare Advantage |
$33.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.32
|
| Rate for Payer: Cigna Commercial |
$55.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.44
|
| Rate for Payer: Oxford Commercial |
$55.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.52
|
|
|
SUTURE STRATA 2-0 CT-1 20CM
|
Facility
|
IP
|
$111.04
|
|
| Hospital Charge Code |
270671506
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.66 |
| Max. Negotiated Rate |
$16.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.66
|
|
|
SUTURE STRATA 2-0 CT-1 30CM
|
Facility
|
IP
|
$86.66
|
|
| Hospital Charge Code |
270671507
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.00
|
|
|
SUTURE STRATA 2-0 CT-1 30CM
|
Facility
|
OP
|
$86.66
|
|
| Hospital Charge Code |
270671507
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$43.33 |
| Rate for Payer: Aetna Commercial |
$26.00
|
| Rate for Payer: Aetna Medicare Advantage |
$26.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.10
|
| Rate for Payer: Cigna Commercial |
$43.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.27
|
| Rate for Payer: Oxford Commercial |
$43.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$43.33
|
|
|
SUTURE STRATA 2-0 MH
|
Facility
|
IP
|
$131.51
|
|
| Hospital Charge Code |
270671508
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$19.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.73
|
|
|
SUTURE STRATA 2-0 MH
|
Facility
|
OP
|
$131.51
|
|
| Hospital Charge Code |
270671508
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.10 |
| Max. Negotiated Rate |
$65.75 |
| Rate for Payer: Aetna Commercial |
$39.45
|
| Rate for Payer: Aetna Medicare Advantage |
$39.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.54
|
| Rate for Payer: Cigna Commercial |
$65.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.10
|
| Rate for Payer: Oxford Commercial |
$65.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.75
|
|
|
SUTURE STRATA 2-0 PDS CT01
|
Facility
|
IP
|
$113.32
|
|
| Hospital Charge Code |
270681809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.00
|
|
|
SUTURE STRATA 2-0 PDS CT01
|
Facility
|
OP
|
$113.32
|
|
| Hospital Charge Code |
270681809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.73 |
| Max. Negotiated Rate |
$56.66 |
| Rate for Payer: Aetna Commercial |
$34.00
|
| Rate for Payer: Aetna Medicare Advantage |
$34.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.90
|
| Rate for Payer: Cigna Commercial |
$56.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.73
|
| Rate for Payer: Oxford Commercial |
$56.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.66
|
|
|
SUTURE STRATA 2-0 PGA/PCL 20CM
|
Facility
|
IP
|
$111.04
|
|
| Hospital Charge Code |
270672361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.66 |
| Max. Negotiated Rate |
$16.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.66
|
|