|
BIT DRILL 2.8MM
|
Facility
|
IP
|
$660.00
|
|
| Hospital Charge Code |
270677147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
BIT DRILL 2.8MM
|
Facility
|
IP
|
$890.00
|
|
| Hospital Charge Code |
270641389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.50 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.50
|
|
|
BIT DRILL 2.8MM
|
Facility
|
OP
|
$660.00
|
|
| Hospital Charge Code |
270677147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.80 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$198.00
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.80
|
| Rate for Payer: Oxford Commercial |
$330.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$330.00
|
|
|
BIT DRILL 2.8MM
|
Facility
|
OP
|
$890.00
|
|
| Hospital Charge Code |
270641389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.70 |
| Max. Negotiated Rate |
$445.00 |
| Rate for Payer: Aetna Commercial |
$267.00
|
| Rate for Payer: Aetna Medicare Advantage |
$267.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.95
|
| Rate for Payer: Cigna Commercial |
$445.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.70
|
| Rate for Payer: Oxford Commercial |
$445.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$445.00
|
|
|
BIT DRILL 2.8MM CALIBRATED
|
Facility
|
IP
|
$545.00
|
|
| Hospital Charge Code |
270646197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$81.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
BIT DRILL 2.8MM CALIBRATED
|
Facility
|
OP
|
$545.00
|
|
| Hospital Charge Code |
270646197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.85 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$70.85
|
| Rate for Payer: Oxford Commercial |
$272.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$272.50
|
|
|
BIT DRILL 2.8mm LONG DB28
|
Facility
|
IP
|
$396.85
|
|
| Hospital Charge Code |
270634970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.53 |
| Max. Negotiated Rate |
$59.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.53
|
|
|
BIT DRILL 2.8mm LONG DB28
|
Facility
|
OP
|
$396.85
|
|
| Hospital Charge Code |
270634970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.59 |
| Max. Negotiated Rate |
$198.43 |
| Rate for Payer: Aetna Commercial |
$119.06
|
| Rate for Payer: Aetna Medicare Advantage |
$119.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.20
|
| Rate for Payer: Cigna Commercial |
$198.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.59
|
| Rate for Payer: Oxford Commercial |
$198.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$198.43
|
|
|
BIT DRILL 2.8mm SHORT MSDC28
|
Facility
|
IP
|
$345.00
|
|
| Hospital Charge Code |
270646196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.75 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.75
|
|
|
BIT DRILL 2.8mm SHORT MSDC28
|
Facility
|
OP
|
$345.00
|
|
| Hospital Charge Code |
270646196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.85 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Aetna Commercial |
$103.50
|
| Rate for Payer: Aetna Medicare Advantage |
$103.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.97
|
| Rate for Payer: Cigna Commercial |
$172.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.85
|
| Rate for Payer: Oxford Commercial |
$172.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$172.50
|
|
|
BIT DRILL 3.0MM
|
Facility
|
OP
|
$395.00
|
|
| Hospital Charge Code |
270677001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.35 |
| Max. Negotiated Rate |
$197.50 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna Medicare Advantage |
$118.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.72
|
| Rate for Payer: Cigna Commercial |
$197.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.35
|
| Rate for Payer: Oxford Commercial |
$197.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$197.50
|
|
|
BIT DRILL 3.0MM
|
Facility
|
IP
|
$575.00
|
|
| Hospital Charge Code |
270664800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
|
|
BIT DRILL 3.0MM
|
Facility
|
IP
|
$395.00
|
|
| Hospital Charge Code |
270677001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
BIT DRILL 3.0MM
|
Facility
|
OP
|
$575.00
|
|
| Hospital Charge Code |
270664800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.75 |
| Max. Negotiated Rate |
$287.50 |
| Rate for Payer: Aetna Commercial |
$172.50
|
| Rate for Payer: Aetna Medicare Advantage |
$172.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$146.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$146.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$146.62
|
| Rate for Payer: Cigna Commercial |
$287.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.75
|
| Rate for Payer: Oxford Commercial |
$287.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$287.50
|
|
|
BIT DRILL 3.1mm X 204mm
|
Facility
|
IP
|
$597.40
|
|
| Hospital Charge Code |
270640120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.61 |
| Max. Negotiated Rate |
$89.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.61
|
|
|
BIT DRILL 3.1mm X 204mm
|
Facility
|
OP
|
$597.40
|
|
| Hospital Charge Code |
270640120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna Commercial |
$179.22
|
| Rate for Payer: Aetna Medicare Advantage |
$179.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$152.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$152.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$152.34
|
| Rate for Payer: Cigna Commercial |
$298.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$77.66
|
| Rate for Payer: Oxford Commercial |
$298.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$298.70
|
|
|
BIT DRILL 3.2mm
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270671871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Oxford Commercial |
$212.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$212.50
|
|
|
BIT DRILL 3.2mm
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270671871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
BIT DRILL 3.2X145 31031****
|
Facility
|
OP
|
$331.70
|
|
| Hospital Charge Code |
270636029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.12 |
| Max. Negotiated Rate |
$165.85 |
| Rate for Payer: Aetna Commercial |
$99.51
|
| Rate for Payer: Aetna Medicare Advantage |
$99.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.58
|
| Rate for Payer: Cigna Commercial |
$165.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.12
|
| Rate for Payer: Oxford Commercial |
$165.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$165.85
|
|
|
BIT DRILL 3.2X145 31031****
|
Facility
|
IP
|
$331.70
|
|
| Hospital Charge Code |
270636029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.76 |
| Max. Negotiated Rate |
$49.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.76
|
|
|
BIT DRILL 3.5 700349
|
Facility
|
IP
|
$950.00
|
|
| Hospital Charge Code |
270648061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
|
|
BIT DRILL 3.5 700349
|
Facility
|
OP
|
$950.00
|
|
| Hospital Charge Code |
270648061
|
|
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
|
|
|
BIT DRILL 3.5 702450
|
Facility
|
IP
|
$2,150.00
|
|
| Hospital Charge Code |
270648763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$322.50 |
| Max. Negotiated Rate |
$520.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$430.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$520.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.50
|
|
|
BIT DRILL 3.5 702450
|
Facility
|
OP
|
$2,150.00
|
|
| Hospital Charge Code |
270648763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$322.50 |
| Max. Negotiated Rate |
$1,075.00 |
| Rate for Payer: Aetna Commercial |
$645.00
|
| Rate for Payer: Aetna Medicare Advantage |
$645.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$548.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$548.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$430.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$548.25
|
| Rate for Payer: Cigna Commercial |
$1,075.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$520.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.50
|
|
|
BIT DRILL 3.5MM
|
Facility
|
OP
|
$695.00
|
|
| Hospital Charge Code |
270648918
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.35 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Aetna Commercial |
$208.50
|
| Rate for Payer: Aetna Medicare Advantage |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$177.22
|
| Rate for Payer: Cigna Commercial |
$347.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.35
|
| Rate for Payer: Oxford Commercial |
$347.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$347.50
|
|