|
WAND OPES 90DEGREE LOW PROFILE
|
Facility
|
OP
|
$868.00
|
|
| Hospital Charge Code |
270636746
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.84 |
| Max. Negotiated Rate |
$434.00 |
| Rate for Payer: Aetna Commercial |
$260.40
|
| Rate for Payer: Aetna Medicare Advantage |
$260.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.34
|
| Rate for Payer: Cigna Commercial |
$434.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.84
|
| Rate for Payer: Oxford Commercial |
$434.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$434.00
|
|
|
WAND OPES ABLATOR MENISECTOMY
|
Facility
|
OP
|
$570.45
|
|
| Hospital Charge Code |
270636744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.16 |
| Max. Negotiated Rate |
$285.23 |
| Rate for Payer: Aetna Commercial |
$171.13
|
| Rate for Payer: Aetna Medicare Advantage |
$171.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$145.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$145.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$145.46
|
| Rate for Payer: Cigna Commercial |
$285.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.16
|
| Rate for Payer: Oxford Commercial |
$285.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$285.23
|
|
|
WAND OPES ABLATOR MENISECTOMY
|
Facility
|
IP
|
$570.45
|
|
| Hospital Charge Code |
270636744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.57 |
| Max. Negotiated Rate |
$85.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.57
|
|
|
WAND PORT APOLLO RF 90 DEG
|
Facility
|
IP
|
$950.00
|
|
| Hospital Charge Code |
270681362
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
|
|
WAND PORT APOLLO RF 90 DEG
|
Facility
|
OP
|
$950.00
|
|
| Hospital Charge Code |
270681362
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$285.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$242.25
|
| Rate for Payer: Cigna Commercial |
$475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$123.50
|
| Rate for Payer: Oxford Commercial |
$475.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$475.00
|
|
|
WAND PROCISE XP
|
Facility
|
IP
|
$1,175.00
|
|
| Hospital Charge Code |
270683545
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.25 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.25
|
|
|
WAND PROCISE XP
|
Facility
|
OP
|
$1,175.00
|
|
| Hospital Charge Code |
270683545
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.75 |
| Max. Negotiated Rate |
$587.50 |
| Rate for Payer: Aetna Commercial |
$352.50
|
| Rate for Payer: Aetna Medicare Advantage |
$352.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$299.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$299.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$299.62
|
| Rate for Payer: Cigna Commercial |
$587.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.75
|
| Rate for Payer: Oxford Commercial |
$587.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$587.50
|
|
|
WAND REFLEX ULTRA PTR
|
Facility
|
OP
|
$1,335.00
|
|
| Hospital Charge Code |
270663823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.55 |
| Max. Negotiated Rate |
$667.50 |
| Rate for Payer: Aetna Commercial |
$400.50
|
| Rate for Payer: Aetna Medicare Advantage |
$400.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$340.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$340.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$340.43
|
| Rate for Payer: Cigna Commercial |
$667.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$173.55
|
| Rate for Payer: Oxford Commercial |
$667.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$667.50
|
|
|
WAND REFLEX ULTRA PTR
|
Facility
|
IP
|
$1,335.00
|
|
| Hospital Charge Code |
270663823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$200.25 |
| Max. Negotiated Rate |
$200.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.25
|
|
|
WAND TURBOVAC 90 IFS AMBIENT
|
Facility
|
OP
|
$2,290.00
|
|
| Hospital Charge Code |
270646584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$297.70 |
| Max. Negotiated Rate |
$1,145.00 |
| Rate for Payer: Aetna Commercial |
$687.00
|
| Rate for Payer: Aetna Medicare Advantage |
$687.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$583.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$583.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$583.95
|
| Rate for Payer: Cigna Commercial |
$1,145.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$297.70
|
| Rate for Payer: Oxford Commercial |
$1,145.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,145.00
|
|
|
WAND TURBOVAC 90 IFS AMBIENT
|
Facility
|
IP
|
$2,290.00
|
|
| Hospital Charge Code |
270646584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$343.50 |
| Max. Negotiated Rate |
$343.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.50
|
|
|
WAND TURBOVAC S50 IFS AMBIENT
|
Facility
|
OP
|
$2,290.00
|
|
| Hospital Charge Code |
270673244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$297.70 |
| Max. Negotiated Rate |
$1,145.00 |
| Rate for Payer: Aetna Commercial |
$687.00
|
| Rate for Payer: Aetna Medicare Advantage |
$687.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$583.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$583.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$583.95
|
| Rate for Payer: Cigna Commercial |
$1,145.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$297.70
|
| Rate for Payer: Oxford Commercial |
$1,145.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,145.00
|
|
|
WAND TURBOVAC S50 IFS AMBIENT
|
Facility
|
IP
|
$2,290.00
|
|
| Hospital Charge Code |
270673244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$343.50 |
| Max. Negotiated Rate |
$343.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.50
|
|
|
WAND TURB REDU ARIS
|
Facility
|
IP
|
$1,650.00
|
|
| Hospital Charge Code |
270702050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.50 |
| Max. Negotiated Rate |
$399.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$399.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$247.50
|
|
|
WAND TURB REDU ARIS
|
Facility
|
OP
|
$1,650.00
|
|
| Hospital Charge Code |
270702050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.50 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: Aetna Commercial |
$495.00
|
| Rate for Payer: Aetna Medicare Advantage |
$495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$330.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$420.75
|
| Rate for Payer: Cigna Commercial |
$825.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$399.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$247.50
|
|
|
WAND ULTRA REFLEX 45 DEG ANGLE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270639313
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
WAND ULTRA REFLEX 45 DEG ANGLE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270639313
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
WAND WEREWOLF FLOW 50
|
Facility
|
OP
|
$1,000.00
|
|
| Hospital Charge Code |
270692435
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna Commercial |
$300.00
|
| Rate for Payer: Aetna Medicare Advantage |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$255.00
|
| Rate for Payer: Cigna Commercial |
$500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.00
|
| Rate for Payer: Oxford Commercial |
$500.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$500.00
|
|
|
WAND WEREWOLF FLOW 50
|
Facility
|
IP
|
$1,000.00
|
|
| Hospital Charge Code |
270692435
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
|
|
WAND WEREWOLF FLOW 90
|
Facility
|
OP
|
$1,000.00
|
|
| Hospital Charge Code |
270692436
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna Commercial |
$300.00
|
| Rate for Payer: Aetna Medicare Advantage |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$255.00
|
| Rate for Payer: Cigna Commercial |
$500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.00
|
| Rate for Payer: Oxford Commercial |
$500.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$500.00
|
|
|
WAND WEREWOLF FLOW 90
|
Facility
|
IP
|
$1,000.00
|
|
| Hospital Charge Code |
270692436
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
|
|
WANGENSTEIN MACHINE***
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
8002164
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Aetna Commercial |
$7.20
|
| Rate for Payer: Aetna Medicare Advantage |
$7.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.12
|
| Rate for Payer: Cigna Commercial |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.12
|
| Rate for Payer: Oxford Commercial |
$12.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.00
|
|
|
WANGENSTEIN MACHINE***
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
8002164
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.60
|
|
|
WARFARIN 10 MG TAB
|
Facility
|
IP
|
$21.37
|
|
|
Service Code
|
NDC 56017475
|
| Hospital Charge Code |
60627514
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$3.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
|
|
WARFARIN 10 MG TAB
|
Facility
|
OP
|
$21.37
|
|
|
Service Code
|
NDC 56017475
|
| Hospital Charge Code |
60627514
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$10.69 |
| Rate for Payer: Aetna Commercial |
$6.41
|
| Rate for Payer: Aetna Medicare Advantage |
$6.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.45
|
| Rate for Payer: Cigna Commercial |
$10.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.78
|
| Rate for Payer: Oxford Commercial |
$10.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.69
|
|