|
WASHER 7.0MM
|
Facility
|
IP
|
$111.40
|
|
| Hospital Charge Code |
270604108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$26.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.71
|
|
|
WASHER 7.0MM
|
Facility
|
OP
|
$105.00
|
|
| Hospital Charge Code |
270656907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$31.50
|
| Rate for Payer: Aetna Medicare Advantage |
$31.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.77
|
| Rate for Payer: Cigna Commercial |
$52.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.65
|
| Rate for Payer: Oxford Commercial |
$52.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.50
|
|
|
WASHER 7.5MM
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700708
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$101.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$84.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
|
|
WASHER 7.5MM
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700708
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$126.00
|
| Rate for Payer: Aetna Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$107.10
|
| Rate for Payer: Cigna Commercial |
$210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
|
|
WASHER 7MM
|
Facility
|
IP
|
$160.50
|
|
| Hospital Charge Code |
270663087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$38.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.07
|
|
|
WASHER 7MM
|
Facility
|
OP
|
$160.50
|
|
| Hospital Charge Code |
270663087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$80.25 |
| Rate for Payer: Aetna Commercial |
$48.15
|
| Rate for Payer: Aetna Medicare Advantage |
$48.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.93
|
| Rate for Payer: Cigna Commercial |
$80.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.07
|
|
|
WASHER 7MM 219.98
|
Facility
|
IP
|
$2,490.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691945
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$373.50 |
| Max. Negotiated Rate |
$602.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$498.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$602.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$373.50
|
|
|
WASHER 7MM 219.98
|
Facility
|
OP
|
$2,490.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691945
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$373.50 |
| Max. Negotiated Rate |
$1,245.00 |
| Rate for Payer: Aetna Commercial |
$747.00
|
| Rate for Payer: Aetna Medicare Advantage |
$747.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$634.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$634.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$498.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$634.95
|
| Rate for Payer: Cigna Commercial |
$1,245.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$602.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$373.50
|
|
|
WASHER 7MM RED
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
270674293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$84.00
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.40
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$140.00
|
|
|
WASHER 7MM RED
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
270674293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|
|
WASHER ASNIS FOR 5MM SCREWS
|
Facility
|
IP
|
$245.00
|
|
| Hospital Charge Code |
270668346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$59.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
|
|
WASHER ASNIS FOR 5MM SCREWS
|
Facility
|
OP
|
$245.00
|
|
| Hospital Charge Code |
270668346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna Commercial |
$73.50
|
| Rate for Payer: Aetna Medicare Advantage |
$73.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.48
|
| Rate for Payer: Cigna Commercial |
$122.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
|
|
WASHER ATHX SPIKED 14 AR1349
|
Facility
|
OP
|
$1,334.45
|
|
| Hospital Charge Code |
270614426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$200.17 |
| Max. Negotiated Rate |
$667.23 |
| Rate for Payer: Aetna Commercial |
$400.33
|
| Rate for Payer: Aetna Medicare Advantage |
$400.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$340.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$340.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$266.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$340.28
|
| Rate for Payer: Cigna Commercial |
$667.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.17
|
|
|
WASHER ATHX SPIKED 14 AR1349
|
Facility
|
IP
|
$1,334.45
|
|
| Hospital Charge Code |
270614426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$200.17 |
| Max. Negotiated Rate |
$322.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$266.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.17
|
|
|
WASHER ATK ANCHOR 14MM 381014
|
Facility
|
IP
|
$1,012.85
|
|
| Hospital Charge Code |
270617807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.93 |
| Max. Negotiated Rate |
$245.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$202.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$245.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.93
|
|
|
WASHER ATK ANCHOR 14MM 381014
|
Facility
|
OP
|
$1,012.85
|
|
| Hospital Charge Code |
270617807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.93 |
| Max. Negotiated Rate |
$506.43 |
| Rate for Payer: Aetna Commercial |
$303.86
|
| Rate for Payer: Aetna Medicare Advantage |
$303.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$258.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$258.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$202.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$258.28
|
| Rate for Payer: Cigna Commercial |
$506.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$245.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.93
|
|
|
WASHER ATK ANCHOR 18MM 381018
|
Facility
|
OP
|
$1,349.65
|
|
| Hospital Charge Code |
270610577
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.45 |
| Max. Negotiated Rate |
$674.83 |
| Rate for Payer: Aetna Commercial |
$404.89
|
| Rate for Payer: Aetna Medicare Advantage |
$404.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$344.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$344.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$269.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$344.16
|
| Rate for Payer: Cigna Commercial |
$674.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$326.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.45
|
|
|
WASHER ATK ANCHOR 18MM 381018
|
Facility
|
IP
|
$1,349.65
|
|
| Hospital Charge Code |
270610577
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.45 |
| Max. Negotiated Rate |
$326.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$269.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$326.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.45
|
|
|
WASHER ATK FOR SCREW 904314
|
Facility
|
IP
|
$1,353.65
|
|
| Hospital Charge Code |
270609651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.05 |
| Max. Negotiated Rate |
$327.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$270.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$327.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$203.05
|
|
|
WASHER ATK FOR SCREW 904314
|
Facility
|
OP
|
$1,353.65
|
|
| Hospital Charge Code |
270609651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.05 |
| Max. Negotiated Rate |
$676.83 |
| Rate for Payer: Aetna Commercial |
$406.10
|
| Rate for Payer: Aetna Medicare Advantage |
$406.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$345.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$345.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$270.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$345.18
|
| Rate for Payer: Cigna Commercial |
$676.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$327.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$203.05
|
|
|
WASHER ATK LOCK 16MM 908436
|
Facility
|
IP
|
$1,724.85
|
|
| Hospital Charge Code |
270613297
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.73 |
| Max. Negotiated Rate |
$417.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$344.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$417.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.73
|
|
|
WASHER ATK LOCK 16MM 908436
|
Facility
|
OP
|
$1,724.85
|
|
| Hospital Charge Code |
270613297
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.73 |
| Max. Negotiated Rate |
$862.42 |
| Rate for Payer: Aetna Commercial |
$517.46
|
| Rate for Payer: Aetna Medicare Advantage |
$517.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$344.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.84
|
| Rate for Payer: Cigna Commercial |
$862.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$417.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.73
|
|
|
WASHER ATK SCREW 18MM 905418
|
Facility
|
IP
|
$1,532.70
|
|
| Hospital Charge Code |
270627983
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.91 |
| Max. Negotiated Rate |
$370.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$306.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$370.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$229.91
|
|
|
WASHER ATK SCREW 18MM 905418
|
Facility
|
OP
|
$1,532.70
|
|
| Hospital Charge Code |
270627983
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.91 |
| Max. Negotiated Rate |
$766.35 |
| Rate for Payer: Aetna Commercial |
$459.81
|
| Rate for Payer: Aetna Medicare Advantage |
$459.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$390.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$390.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$306.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$390.84
|
| Rate for Payer: Cigna Commercial |
$766.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$370.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$229.91
|
|
|
WASHER BMT 13MM 245890
|
Facility
|
OP
|
$268.85
|
|
| Hospital Charge Code |
270618212
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.33 |
| Max. Negotiated Rate |
$134.43 |
| Rate for Payer: Aetna Commercial |
$80.66
|
| Rate for Payer: Aetna Medicare Advantage |
$80.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$53.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.56
|
| Rate for Payer: Cigna Commercial |
$134.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.33
|
|