|
BIT DPY DR 5MM PIN FF10503
|
Facility
|
IP
|
$1,127.25
|
|
| Hospital Charge Code |
270612440
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.09 |
| Max. Negotiated Rate |
$169.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.09
|
|
|
BIT DPY DRILL 1355070
|
Facility
|
IP
|
$368.00
|
|
| Hospital Charge Code |
270622989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$55.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.20
|
|
|
BIT DPY DRILL 1355070
|
Facility
|
OP
|
$368.00
|
|
| Hospital Charge Code |
270622989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.84 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$110.40
|
| Rate for Payer: Aetna Medicare Advantage |
$110.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$93.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$93.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$93.84
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$47.84
|
| Rate for Payer: Oxford Commercial |
$184.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$184.00
|
|
|
BIT DPY DRILL 3.8 5242-72-000
|
Facility
|
OP
|
$304.85
|
|
| Hospital Charge Code |
270622954
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.63 |
| Max. Negotiated Rate |
$152.43 |
| Rate for Payer: Aetna Commercial |
$91.45
|
| Rate for Payer: Aetna Medicare Advantage |
$91.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.74
|
| Rate for Payer: Cigna Commercial |
$152.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.63
|
| Rate for Payer: Oxford Commercial |
$152.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$152.43
|
|
|
BIT DPY DRILL 3.8 5242-72-000
|
Facility
|
IP
|
$304.85
|
|
| Hospital Charge Code |
270622954
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.73 |
| Max. Negotiated Rate |
$45.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.73
|
|
|
BIT DPY DRILL 4.8 8242-73-000
|
Facility
|
OP
|
$326.45
|
|
| Hospital Charge Code |
270622955
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.44 |
| Max. Negotiated Rate |
$163.22 |
| Rate for Payer: Aetna Commercial |
$97.94
|
| Rate for Payer: Aetna Medicare Advantage |
$97.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.24
|
| Rate for Payer: Cigna Commercial |
$163.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.44
|
| Rate for Payer: Oxford Commercial |
$163.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$163.22
|
|
|
BIT DPY DRILL 4.8 8242-73-000
|
Facility
|
IP
|
$326.45
|
|
| Hospital Charge Code |
270622955
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.97 |
| Max. Negotiated Rate |
$48.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.97
|
|
|
BIT DR 1.1MM
|
Facility
|
OP
|
$62.50
|
|
| Hospital Charge Code |
270603560
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.12 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$18.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.94
|
| Rate for Payer: Cigna Commercial |
$31.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.12
|
| Rate for Payer: Oxford Commercial |
$31.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.25
|
|
|
BIT DR 1.1MM
|
Facility
|
IP
|
$62.50
|
|
| Hospital Charge Code |
270603560
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$9.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
|
|
BIT DR 1.5MM
|
Facility
|
IP
|
$62.50
|
|
| Hospital Charge Code |
270603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$9.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
|
|
BIT DR 1.5MM
|
Facility
|
OP
|
$62.50
|
|
| Hospital Charge Code |
270603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.12 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$18.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.94
|
| Rate for Payer: Cigna Commercial |
$31.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.12
|
| Rate for Payer: Oxford Commercial |
$31.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.25
|
|
|
BIT DR 2.0MM
|
Facility
|
OP
|
$62.50
|
|
| Hospital Charge Code |
270603563
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.12 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$18.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.94
|
| Rate for Payer: Cigna Commercial |
$31.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.12
|
| Rate for Payer: Oxford Commercial |
$31.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.25
|
|
|
BIT DR 2.0MM
|
Facility
|
IP
|
$62.50
|
|
| Hospital Charge Code |
270603563
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$9.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
|
|
BIT DR 2.0MM LONG
|
Facility
|
OP
|
$69.00
|
|
| Hospital Charge Code |
270603565
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Aetna Medicare Advantage |
$20.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.59
|
| Rate for Payer: Cigna Commercial |
$34.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.97
|
| Rate for Payer: Oxford Commercial |
$34.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.50
|
|
|
BIT DR 2.0MM LONG
|
Facility
|
IP
|
$69.00
|
|
| Hospital Charge Code |
270603565
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$10.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.35
|
|
|
BIT DR 2.7 LONG
|
Facility
|
OP
|
$69.00
|
|
| Hospital Charge Code |
270603568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Aetna Medicare Advantage |
$20.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.59
|
| Rate for Payer: Cigna Commercial |
$34.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.97
|
| Rate for Payer: Oxford Commercial |
$34.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.50
|
|
|
BIT DR 2.7 LONG
|
Facility
|
IP
|
$69.00
|
|
| Hospital Charge Code |
270603568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$10.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.35
|
|
|
BIT DR 2.7MM
|
Facility
|
OP
|
$62.50
|
|
| Hospital Charge Code |
270603569
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.12 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$18.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.94
|
| Rate for Payer: Cigna Commercial |
$31.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.12
|
| Rate for Payer: Oxford Commercial |
$31.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.25
|
|
|
BIT DR 2.7MM
|
Facility
|
IP
|
$62.50
|
|
| Hospital Charge Code |
270603569
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$9.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
|
|
BIT DR 3.5MM
|
Facility
|
IP
|
$104.00
|
|
| Hospital Charge Code |
270603573
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
|
|
BIT DR 3.5MM
|
Facility
|
OP
|
$104.00
|
|
| Hospital Charge Code |
270603573
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.52 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare Advantage |
$31.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.52
|
| Rate for Payer: Cigna Commercial |
$52.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.52
|
| Rate for Payer: Oxford Commercial |
$52.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.00
|
|
|
BIT DR 3.5MM
|
Facility
|
OP
|
$62.50
|
|
| Hospital Charge Code |
270604443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.12 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$18.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.94
|
| Rate for Payer: Cigna Commercial |
$31.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.12
|
| Rate for Payer: Oxford Commercial |
$31.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.25
|
|
|
BIT DR 3.5MM
|
Facility
|
IP
|
$62.50
|
|
| Hospital Charge Code |
270604443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$9.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.38
|
|
|
BIT DR .5MM LONG
|
Facility
|
OP
|
$71.00
|
|
| Hospital Charge Code |
270603562
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$35.50 |
| Rate for Payer: Aetna Commercial |
$21.30
|
| Rate for Payer: Aetna Medicare Advantage |
$21.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.11
|
| Rate for Payer: Cigna Commercial |
$35.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.23
|
| Rate for Payer: Oxford Commercial |
$35.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$35.50
|
|
|
BIT DR .5MM LONG
|
Facility
|
IP
|
$71.00
|
|
| Hospital Charge Code |
270603562
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$10.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
|