|
TAP FOR 6.5MM CANC BONE SCREW
|
Facility
|
OP
|
$1,059.00
|
|
| Hospital Charge Code |
270671821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.67 |
| Max. Negotiated Rate |
$529.50 |
| Rate for Payer: Aetna Commercial |
$317.70
|
| Rate for Payer: Aetna Medicare Advantage |
$317.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$270.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$270.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$270.05
|
| Rate for Payer: Cigna Commercial |
$529.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.67
|
| Rate for Payer: Oxford Commercial |
$529.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$529.50
|
|
|
TAP FOR 6.5MM CANC BONE SCREW
|
Facility
|
IP
|
$1,059.00
|
|
| Hospital Charge Code |
270671821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.85 |
| Max. Negotiated Rate |
$158.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.85
|
|
|
TAP FOR SCREW
|
Facility
|
IP
|
$3,455.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$518.31 |
| Max. Negotiated Rate |
$836.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$691.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$836.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$518.31
|
|
|
TAP FOR SCREW
|
Facility
|
OP
|
$3,455.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$518.31 |
| Max. Negotiated Rate |
$1,727.70 |
| Rate for Payer: Aetna Commercial |
$1,036.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,036.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$881.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$881.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$691.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$881.13
|
| Rate for Payer: Cigna Commercial |
$1,727.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$836.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$518.31
|
|
|
TAP INTERNAL 6.5mm
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270637466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
TAP INTERNAL 6.5mm
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270637466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$450.00
|
| Rate for Payer: Aetna Medicare Advantage |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
TAP MOUNTAINEER 3.0MM
|
Facility
|
OP
|
$1,912.50
|
|
| Hospital Charge Code |
270663782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$248.62 |
| Max. Negotiated Rate |
$956.25 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare Advantage |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$487.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$487.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$487.69
|
| Rate for Payer: Cigna Commercial |
$956.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$248.62
|
| Rate for Payer: Oxford Commercial |
$956.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$286.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$956.25
|
|
|
TAP MOUNTAINEER 3.0MM
|
Facility
|
IP
|
$1,912.50
|
|
| Hospital Charge Code |
270663782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$286.88 |
| Max. Negotiated Rate |
$286.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$286.88
|
|
|
TAP OVERWATCH EXTEND 5.5X40MM
|
Facility
|
OP
|
$5,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.50 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna Commercial |
$1,575.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,575.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,338.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,338.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,338.75
|
| Rate for Payer: Cigna Commercial |
$2,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,270.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$787.50
|
|
|
TAP OVERWATCH EXTEND 5.5X40MM
|
Facility
|
IP
|
$5,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.50 |
| Max. Negotiated Rate |
$1,270.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,050.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,270.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$787.50
|
|
|
TAPR M/L 9 STD RECD NECK LNGTH
|
Facility
|
IP
|
$15,359.40
|
|
| Hospital Charge Code |
270668332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,303.91 |
| Max. Negotiated Rate |
$3,716.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,071.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,716.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,303.91
|
|
|
TAPR M/L 9 STD RECD NECK LNGTH
|
Facility
|
OP
|
$15,359.40
|
|
| Hospital Charge Code |
270668332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,303.91 |
| Max. Negotiated Rate |
$7,679.70 |
| Rate for Payer: Aetna Commercial |
$4,607.82
|
| Rate for Payer: Aetna Medicare Advantage |
$4,607.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,916.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,916.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,071.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,916.65
|
| Rate for Payer: Cigna Commercial |
$7,679.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,716.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,303.91
|
|
|
TAPS
|
Facility
|
IP
|
$3,075.00
|
|
| Hospital Charge Code |
270703021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.25 |
| Max. Negotiated Rate |
$744.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$615.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$744.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$461.25
|
|
|
TAPS
|
Facility
|
OP
|
$3,075.00
|
|
| Hospital Charge Code |
270703021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.25 |
| Max. Negotiated Rate |
$1,537.50 |
| Rate for Payer: Aetna Commercial |
$922.50
|
| Rate for Payer: Aetna Medicare Advantage |
$922.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$784.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$784.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$615.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$784.12
|
| Rate for Payer: Cigna Commercial |
$1,537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$744.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$461.25
|
|
|
TAP SURGICAL 5.5MM GPS
|
Facility
|
OP
|
$6,190.00
|
|
| Hospital Charge Code |
270696765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$804.70 |
| Max. Negotiated Rate |
$3,095.00 |
| Rate for Payer: Aetna Commercial |
$1,857.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,857.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,578.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,578.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,578.45
|
| Rate for Payer: Cigna Commercial |
$3,095.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$804.70
|
| Rate for Payer: Oxford Commercial |
$3,095.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$928.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,095.00
|
|
|
TAP SURGICAL 5.5MM GPS
|
Facility
|
IP
|
$6,190.00
|
|
| Hospital Charge Code |
270696765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$928.50 |
| Max. Negotiated Rate |
$928.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$928.50
|
|
|
TAP SYN 4.0 325.12
|
Facility
|
OP
|
$1,503.25
|
|
| Hospital Charge Code |
270609420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.49 |
| Max. Negotiated Rate |
$751.62 |
| Rate for Payer: Aetna Commercial |
$450.98
|
| Rate for Payer: Aetna Medicare Advantage |
$450.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$383.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$383.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$383.33
|
| Rate for Payer: Cigna Commercial |
$751.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.49
|
|
|
TAP SYN 4.0 325.12
|
Facility
|
IP
|
$1,503.25
|
|
| Hospital Charge Code |
270609420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.49 |
| Max. Negotiated Rate |
$363.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.49
|
|
|
TAP SYN CANN SCREW 7.0 311.69
|
Facility
|
IP
|
$2,289.65
|
|
| Hospital Charge Code |
270605009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.45 |
| Max. Negotiated Rate |
$554.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$457.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$554.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.45
|
|
|
TAP SYN CANN SCREW 7.0 311.69
|
Facility
|
OP
|
$2,289.65
|
|
| Hospital Charge Code |
270605009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.45 |
| Max. Negotiated Rate |
$1,144.83 |
| Rate for Payer: Cigna Commercial |
$1,144.83
|
| Rate for Payer: Aetna Commercial |
$686.89
|
| Rate for Payer: Aetna Medicare Advantage |
$686.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$583.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$583.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$457.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$583.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$554.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.45
|
|
|
TAP SYN CANN SCREW 7.3 311.68
|
Facility
|
IP
|
$2,309.65
|
|
| Hospital Charge Code |
270605097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$346.45 |
| Max. Negotiated Rate |
$558.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$461.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$558.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$346.45
|
|
|
TAP SYN CANN SCREW 7.3 311.68
|
Facility
|
OP
|
$2,309.65
|
|
| Hospital Charge Code |
270605097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$346.45 |
| Max. Negotiated Rate |
$1,154.83 |
| Rate for Payer: Aetna Commercial |
$692.89
|
| Rate for Payer: Aetna Medicare Advantage |
$692.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$588.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$588.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$461.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$588.96
|
| Rate for Payer: Cigna Commercial |
$1,154.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$558.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$346.45
|
|
|
TAP SYN CORT 3.5 ***
|
Facility
|
OP
|
$192.00
|
|
| Hospital Charge Code |
270601821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$57.60
|
| Rate for Payer: Aetna Medicare Advantage |
$57.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.96
|
| Rate for Payer: Cigna Commercial |
$96.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.96
|
| Rate for Payer: Oxford Commercial |
$96.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$96.00
|
|
|
TAP SYN CORT 3.5 ***
|
Facility
|
IP
|
$192.00
|
|
| Hospital Charge Code |
270601821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.80
|
|
|
TAP SYN CORT 3.5 311.33
|
Facility
|
IP
|
$682.45
|
|
| Hospital Charge Code |
270604142
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.37 |
| Max. Negotiated Rate |
$165.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.37
|
|