|
BIT DRILL 3-FLUTED RAD 3.2x145
|
Facility
|
OP
|
$1,004.25
|
|
| Hospital Charge Code |
270637810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.55 |
| Max. Negotiated Rate |
$502.12 |
| Rate for Payer: Aetna Commercial |
$301.27
|
| Rate for Payer: Aetna Medicare Advantage |
$301.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$256.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$256.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$256.08
|
| Rate for Payer: Cigna Commercial |
$502.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.55
|
| Rate for Payer: Oxford Commercial |
$502.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$502.12
|
|
|
BIT DRILL 3-FLUTED RAD 3.2x145
|
Facility
|
IP
|
$1,004.25
|
|
| Hospital Charge Code |
270637810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.64 |
| Max. Negotiated Rate |
$150.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.64
|
|
|
BIT DRILL 4.0mm LONG DB40L
|
Facility
|
IP
|
$396.85
|
|
| Hospital Charge Code |
270634969
|
|
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 4.0mm LONG DB40L
|
Facility
|
OP
|
$396.85
|
|
| Hospital Charge Code |
270634969
|
|
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 4.0mm SHORT DB4OS
|
Facility
|
OP
|
$396.85
|
|
| Hospital Charge Code |
270634968
|
|
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 4.0mm SHORT DB4OS
|
Facility
|
IP
|
$396.85
|
|
| Hospital Charge Code |
270634968
|
|
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 4.2x180MM STERILE
|
Facility
|
OP
|
$1,275.00
|
|
| Hospital Charge Code |
270648349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$637.50 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare Advantage |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$325.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$325.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$325.12
|
| Rate for Payer: Cigna Commercial |
$637.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.75
|
| Rate for Payer: Oxford Commercial |
$637.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$191.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$637.50
|
|
|
BIT DRILL 4.2x180MM STERILE
|
Facility
|
IP
|
$1,275.00
|
|
| Hospital Charge Code |
270648349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$191.25 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$191.25
|
|
|
BIT DRILL AO SMALL 4.2x300MM
|
Facility
|
IP
|
$1,350.00
|
|
| Hospital Charge Code |
270651329
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.50 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.50
|
|
|
BIT DRILL AO SMALL 4.2x300MM
|
Facility
|
OP
|
$1,350.00
|
|
| Hospital Charge Code |
270651329
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.50 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare Advantage |
$405.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$344.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$344.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$344.25
|
| Rate for Payer: Cigna Commercial |
$675.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$175.50
|
| Rate for Payer: Oxford Commercial |
$675.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$675.00
|
|
|
BIT DRILL CANN 10MM TAPERED
|
Facility
|
OP
|
$2,157.85
|
|
| Hospital Charge Code |
270677274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$280.52 |
| Max. Negotiated Rate |
$1,078.92 |
| Rate for Payer: Aetna Commercial |
$647.36
|
| Rate for Payer: Aetna Medicare Advantage |
$647.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$550.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$550.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$550.25
|
| Rate for Payer: Cigna Commercial |
$1,078.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$280.52
|
| Rate for Payer: Oxford Commercial |
$1,078.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$323.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,078.92
|
|
|
BIT DRILL CANN 10MM TAPERED
|
Facility
|
IP
|
$2,157.85
|
|
| Hospital Charge Code |
270677274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$323.68 |
| Max. Negotiated Rate |
$323.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$323.68
|
|
|
BIT DRILL CANN 17.0X300 357851
|
Facility
|
IP
|
$3,306.30
|
|
| Hospital Charge Code |
270633851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$495.94 |
| Max. Negotiated Rate |
$495.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$495.94
|
|
|
BIT DRILL CANN 17.0X300 357851
|
Facility
|
OP
|
$3,306.30
|
|
| Hospital Charge Code |
270633851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$429.82 |
| Max. Negotiated Rate |
$1,653.15 |
| Rate for Payer: Aetna Commercial |
$991.89
|
| Rate for Payer: Aetna Medicare Advantage |
$991.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$843.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$843.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$843.11
|
| Rate for Payer: Cigna Commercial |
$1,653.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$429.82
|
| Rate for Payer: Oxford Commercial |
$1,653.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$495.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,653.15
|
|
|
BIT DRILL CANN 2.0x150MM STER
|
Facility
|
IP
|
$1,935.00
|
|
| Hospital Charge Code |
270677400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$290.25 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$290.25
|
|
|
BIT DRILL CANN 2.0x150MM STER
|
Facility
|
OP
|
$1,935.00
|
|
| Hospital Charge Code |
270677400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.55 |
| Max. Negotiated Rate |
$967.50 |
| Rate for Payer: Aetna Commercial |
$580.50
|
| Rate for Payer: Aetna Medicare Advantage |
$580.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$493.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$493.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$493.43
|
| Rate for Payer: Cigna Commercial |
$967.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$251.55
|
| Rate for Payer: Oxford Commercial |
$967.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$290.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$967.50
|
|
|
Bit Drill Cann 5.5
|
Facility
|
IP
|
$1,740.00
|
|
| Hospital Charge Code |
270673705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$261.00
|
|
|
Bit Drill Cann 5.5
|
Facility
|
OP
|
$1,740.00
|
|
| Hospital Charge Code |
270673705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$226.20 |
| Max. Negotiated Rate |
$870.00 |
| Rate for Payer: Aetna Commercial |
$522.00
|
| Rate for Payer: Aetna Medicare Advantage |
$522.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$443.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$443.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$443.70
|
| Rate for Payer: Cigna Commercial |
$870.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$226.20
|
| Rate for Payer: Oxford Commercial |
$870.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$261.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$870.00
|
|
|
BIT DRILL CANN 6.0x10mm
|
Facility
|
IP
|
$3,411.90
|
|
| Hospital Charge Code |
270637690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$511.79 |
| Max. Negotiated Rate |
$511.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$511.79
|
|
|
BIT DRILL CANN 6.0x10mm
|
Facility
|
OP
|
$3,411.90
|
|
| Hospital Charge Code |
270637690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$443.55 |
| Max. Negotiated Rate |
$1,705.95 |
| Rate for Payer: Aetna Commercial |
$1,023.57
|
| Rate for Payer: Aetna Medicare Advantage |
$1,023.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$870.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$870.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$870.03
|
| Rate for Payer: Cigna Commercial |
$1,705.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$443.55
|
| Rate for Payer: Oxford Commercial |
$1,705.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$511.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,705.95
|
|
|
BIT DRILL CANN DISP HBS-DCDH
|
Facility
|
OP
|
$843.25
|
|
| Hospital Charge Code |
270636600
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.62 |
| Max. Negotiated Rate |
$421.62 |
| Rate for Payer: Aetna Commercial |
$252.97
|
| Rate for Payer: Aetna Medicare Advantage |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$215.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$215.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$215.03
|
| Rate for Payer: Cigna Commercial |
$421.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$109.62
|
| Rate for Payer: Oxford Commercial |
$421.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$421.62
|
|
|
BIT DRILL CANN DISP HBS-DCDH
|
Facility
|
IP
|
$843.25
|
|
| Hospital Charge Code |
270636600
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.49 |
| Max. Negotiated Rate |
$126.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.49
|
|
|
BIT DRILL CANN FLEX 16MM
|
Facility
|
OP
|
$3,650.60
|
|
| Hospital Charge Code |
270677231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$474.58 |
| Max. Negotiated Rate |
$1,825.30 |
| Rate for Payer: Aetna Commercial |
$1,095.18
|
| Rate for Payer: Aetna Medicare Advantage |
$1,095.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$930.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$930.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$930.90
|
| Rate for Payer: Cigna Commercial |
$1,825.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$474.58
|
| Rate for Payer: Oxford Commercial |
$1,825.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$547.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,825.30
|
|
|
BIT DRILL CANN FLEX 16MM
|
Facility
|
IP
|
$3,650.60
|
|
| Hospital Charge Code |
270677231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$547.59 |
| Max. Negotiated Rate |
$547.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$547.59
|
|
|
BIT DRILL CANN QC 12x190MM ST
|
Facility
|
IP
|
$2,447.30
|
|
| Hospital Charge Code |
270646675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.10 |
| Max. Negotiated Rate |
$367.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$367.10
|
|