|
BIT DRILL 3.5MM
|
Facility
|
IP
|
$695.00
|
|
| Hospital Charge Code |
270648918
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.25 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
|
|
BIT DRILL 3.5MM 7117-3504
|
Facility
|
OP
|
$730.00
|
|
| Hospital Charge Code |
270647953
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.90 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: Aetna Commercial |
$219.00
|
| Rate for Payer: Aetna Medicare Advantage |
$219.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$186.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$186.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$186.15
|
| Rate for Payer: Cigna Commercial |
$365.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.90
|
| Rate for Payer: Oxford Commercial |
$365.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$365.00
|
|
|
BIT DRILL 3.5MM 7117-3504
|
Facility
|
IP
|
$730.00
|
|
| Hospital Charge Code |
270647953
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.50
|
|
|
BIT DRILL 3.8mm
|
Facility
|
IP
|
$870.00
|
|
| Hospital Charge Code |
270671864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.50 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.50
|
|
|
BIT DRILL 3.8mm
|
Facility
|
OP
|
$870.00
|
|
| Hospital Charge Code |
270671864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.10 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$261.00
|
| Rate for Payer: Aetna Medicare Advantage |
$261.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.85
|
| Rate for Payer: Cigna Commercial |
$435.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.10
|
| Rate for Payer: Oxford Commercial |
$435.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$435.00
|
|
|
BIT DRILL 3.8mm 270mm QC
|
Facility
|
OP
|
$1,100.05
|
|
| Hospital Charge Code |
270650159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.01 |
| Max. Negotiated Rate |
$550.02 |
| Rate for Payer: Aetna Commercial |
$330.01
|
| Rate for Payer: Aetna Medicare Advantage |
$330.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$280.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$280.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$280.51
|
| Rate for Payer: Cigna Commercial |
$550.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.01
|
| Rate for Payer: Oxford Commercial |
$550.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$550.02
|
|
|
BIT DRILL 3.8mm 270mm QC
|
Facility
|
IP
|
$1,100.05
|
|
| Hospital Charge Code |
270650159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.01 |
| Max. Negotiated Rate |
$165.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.01
|
|
|
BIT DRILL 3.8mm 824272000
|
Facility
|
OP
|
$307.60
|
|
| Hospital Charge Code |
270633177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.99 |
| Max. Negotiated Rate |
$153.80 |
| Rate for Payer: Aetna Commercial |
$92.28
|
| Rate for Payer: Aetna Medicare Advantage |
$92.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.44
|
| Rate for Payer: Cigna Commercial |
$153.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.99
|
| Rate for Payer: Oxford Commercial |
$153.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.80
|
|
|
BIT DRILL 3.8mm 824272000
|
Facility
|
IP
|
$307.60
|
|
| Hospital Charge Code |
270633177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.14 |
| Max. Negotiated Rate |
$46.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.14
|
|
|
BIT DRILL 3-FLUTED 2.9/3.2x150
|
Facility
|
IP
|
$762.00
|
|
| Hospital Charge Code |
270662831
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.30 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.30
|
|
|
BIT DRILL 3-FLUTED 2.9/3.2x150
|
Facility
|
OP
|
$762.00
|
|
| Hospital Charge Code |
270662831
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.06 |
| Max. Negotiated Rate |
$381.00 |
| Rate for Payer: Aetna Commercial |
$228.60
|
| Rate for Payer: Aetna Medicare Advantage |
$228.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$194.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$194.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$194.31
|
| Rate for Payer: Cigna Commercial |
$381.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.06
|
| Rate for Payer: Oxford Commercial |
$381.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$381.00
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
IP
|
$741.55
|
|
| Hospital Charge Code |
270679778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.23 |
| Max. Negotiated Rate |
$111.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.23
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
IP
|
$698.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.75 |
| Max. Negotiated Rate |
$169.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$139.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.75
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
OP
|
$741.55
|
|
| Hospital Charge Code |
270679778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$370.77 |
| Rate for Payer: Aetna Commercial |
$222.47
|
| Rate for Payer: Aetna Medicare Advantage |
$222.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.10
|
| Rate for Payer: Cigna Commercial |
$370.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.40
|
| Rate for Payer: Oxford Commercial |
$370.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$370.77
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
OP
|
$954.80
|
|
| Hospital Charge Code |
270647424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$477.40 |
| Rate for Payer: Aetna Commercial |
$286.44
|
| Rate for Payer: Aetna Medicare Advantage |
$286.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$243.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$243.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$243.47
|
| Rate for Payer: Cigna Commercial |
$477.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.12
|
| Rate for Payer: Oxford Commercial |
$477.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$477.40
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
IP
|
$954.80
|
|
| Hospital Charge Code |
270647424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.22 |
| Max. Negotiated Rate |
$143.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
OP
|
$698.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.75 |
| Max. Negotiated Rate |
$349.18 |
| Rate for Payer: Aetna Commercial |
$209.50
|
| Rate for Payer: Aetna Medicare Advantage |
$209.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$139.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.08
|
| Rate for Payer: Cigna Commercial |
$349.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.75
|
|
|
BIT DRILL 3-FLUTED 3.2x145 ST
|
Facility
|
OP
|
$954.80
|
|
| Hospital Charge Code |
270674886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$477.40 |
| Rate for Payer: Aetna Commercial |
$286.44
|
| Rate for Payer: Aetna Medicare Advantage |
$286.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$243.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$243.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$243.47
|
| Rate for Payer: Cigna Commercial |
$477.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.12
|
| Rate for Payer: Oxford Commercial |
$477.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$477.40
|
|
|
BIT DRILL 3-FLUTED 3.2x145 ST
|
Facility
|
IP
|
$954.80
|
|
| Hospital Charge Code |
270674886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.22 |
| Max. Negotiated Rate |
$143.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
OP
|
$1,040.75
|
|
| Hospital Charge Code |
270679779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$135.30 |
| Max. Negotiated Rate |
$520.38 |
| Rate for Payer: Aetna Commercial |
$312.23
|
| Rate for Payer: Aetna Medicare Advantage |
$312.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$265.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$265.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$265.39
|
| Rate for Payer: Cigna Commercial |
$520.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.30
|
| Rate for Payer: Oxford Commercial |
$520.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$520.38
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
OP
|
$1,253.95
|
|
| Hospital Charge Code |
270637809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.01 |
| Max. Negotiated Rate |
$626.98 |
| Rate for Payer: Aetna Commercial |
$376.19
|
| Rate for Payer: Aetna Medicare Advantage |
$376.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$319.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$319.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$319.76
|
| Rate for Payer: Cigna Commercial |
$626.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$163.01
|
| Rate for Payer: Oxford Commercial |
$626.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$626.98
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
IP
|
$1,253.95
|
|
| Hospital Charge Code |
270637809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.09 |
| Max. Negotiated Rate |
$188.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.09
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
IP
|
$1,040.75
|
|
| Hospital Charge Code |
270679779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.11 |
| Max. Negotiated Rate |
$156.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.11
|
|
|
BIT DRILL 3-FLUTED 3.8x270MM
|
Facility
|
IP
|
$1,100.05
|
|
| Hospital Charge Code |
270651085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.01 |
| Max. Negotiated Rate |
$165.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.01
|
|
|
BIT DRILL 3-FLUTED 3.8x270MM
|
Facility
|
OP
|
$1,100.05
|
|
| Hospital Charge Code |
270651085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.01 |
| Max. Negotiated Rate |
$550.02 |
| Rate for Payer: Aetna Commercial |
$330.01
|
| Rate for Payer: Aetna Medicare Advantage |
$330.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$280.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$280.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$280.51
|
| Rate for Payer: Cigna Commercial |
$550.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.01
|
| Rate for Payer: Oxford Commercial |
$550.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$550.02
|
|