|
BIT HMD DR TK 4.2 160 52351870
|
Facility
|
OP
|
$436.85
|
|
| Hospital Charge Code |
270619740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.79 |
| Max. Negotiated Rate |
$218.43 |
| Rate for Payer: Aetna Commercial |
$131.06
|
| Rate for Payer: Aetna Medicare Advantage |
$131.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$111.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$111.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$111.40
|
| Rate for Payer: Cigna Commercial |
$218.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.79
|
| Rate for Payer: Oxford Commercial |
$218.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$218.43
|
|
|
BI TIP FLEX TRODE BT-FT
|
Facility
|
IP
|
$1,925.00
|
|
| Hospital Charge Code |
270691543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$288.75 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.75
|
|
|
BI TIP FLEX TRODE BT-FT
|
Facility
|
OP
|
$1,925.00
|
|
| Hospital Charge Code |
270691543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.25 |
| Max. Negotiated Rate |
$962.50 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Aetna Medicare Advantage |
$577.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$490.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$490.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$490.88
|
| Rate for Payer: Cigna Commercial |
$962.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.25
|
| Rate for Payer: Oxford Commercial |
$962.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$962.50
|
|
|
BITOLTEROL 0.2% INHAL SOLN
|
Facility
|
OP
|
$212.85
|
|
| Hospital Charge Code |
60628576
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$106.42 |
| Rate for Payer: Aetna Commercial |
$63.85
|
| Rate for Payer: Aetna Medicare Advantage |
$63.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.28
|
| Rate for Payer: Cigna Commercial |
$106.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.67
|
| Rate for Payer: Oxford Commercial |
$106.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$106.42
|
|
|
BITOLTEROL 0.2% INHAL SOLN
|
Facility
|
IP
|
$212.85
|
|
| Hospital Charge Code |
60628576
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$31.93 |
| Max. Negotiated Rate |
$31.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.93
|
|
|
BIT RMFG 4.5x145mm
|
Facility
|
OP
|
$318.25
|
|
| Hospital Charge Code |
270651529
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.37 |
| Max. Negotiated Rate |
$159.12 |
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Medicare Advantage |
$95.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.15
|
| Rate for Payer: Cigna Commercial |
$159.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.37
|
| Rate for Payer: Oxford Commercial |
$159.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.12
|
|
|
BIT RMFG 4.5x145mm
|
Facility
|
IP
|
$318.25
|
|
| Hospital Charge Code |
270651529
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.74
|
|
|
BITS/BURRS/BLADES
|
Facility
|
IP
|
$261.00
|
|
| Hospital Charge Code |
270335044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.15 |
| Max. Negotiated Rate |
$39.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.15
|
|
|
BITS/BURRS/BLADES
|
Facility
|
OP
|
$261.00
|
|
| Hospital Charge Code |
270335044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Medicare Advantage |
$78.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.56
|
| Rate for Payer: Cigna Commercial |
$130.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.93
|
| Rate for Payer: Oxford Commercial |
$130.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.50
|
|
|
BIT SCREWDRIVER T15 AO
|
Facility
|
IP
|
$2,747.20
|
|
| Hospital Charge Code |
270703595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.08 |
| Max. Negotiated Rate |
$412.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.08
|
|
|
BIT SCREWDRIVER T15 AO
|
Facility
|
OP
|
$2,747.20
|
|
| Hospital Charge Code |
270703595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.14 |
| Max. Negotiated Rate |
$1,373.60 |
| Rate for Payer: Aetna Commercial |
$824.16
|
| Rate for Payer: Aetna Medicare Advantage |
$824.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$700.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$700.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$700.54
|
| Rate for Payer: Cigna Commercial |
$1,373.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$357.14
|
| Rate for Payer: Oxford Commercial |
$1,373.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,373.60
|
|
|
BIT SDK DR 13M 571-636
|
Facility
|
IP
|
$1,475.25
|
|
| Hospital Charge Code |
270607300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.29 |
| Max. Negotiated Rate |
$221.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.29
|
|
|
BIT SDK DR 13M 571-636
|
Facility
|
OP
|
$1,475.25
|
|
| Hospital Charge Code |
270607300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$191.78 |
| Max. Negotiated Rate |
$737.62 |
| Rate for Payer: Aetna Commercial |
$442.57
|
| Rate for Payer: Aetna Medicare Advantage |
$442.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.19
|
| Rate for Payer: Cigna Commercial |
$737.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$191.78
|
| Rate for Payer: Oxford Commercial |
$737.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$737.62
|
|
|
BIT SDK DR 13MM 871-616
|
Facility
|
OP
|
$1,328.85
|
|
| Hospital Charge Code |
270609813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$664.42 |
| Rate for Payer: Aetna Commercial |
$398.65
|
| Rate for Payer: Aetna Medicare Advantage |
$398.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$338.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$338.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$338.86
|
| Rate for Payer: Cigna Commercial |
$664.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.75
|
| Rate for Payer: Oxford Commercial |
$664.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$199.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$664.42
|
|
|
BIT SDK DR 13MM 871-616
|
Facility
|
IP
|
$1,328.85
|
|
| Hospital Charge Code |
270609813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.33 |
| Max. Negotiated Rate |
$199.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$199.33
|
|
|
BIT SDK DR 1.7 4MM 61712
|
Facility
|
OP
|
$769.65
|
|
| Hospital Charge Code |
270610685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.05 |
| Max. Negotiated Rate |
$384.82 |
| Rate for Payer: Aetna Commercial |
$230.90
|
| Rate for Payer: Aetna Medicare Advantage |
$230.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$196.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$196.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$196.26
|
| Rate for Payer: Cigna Commercial |
$384.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.05
|
| Rate for Payer: Oxford Commercial |
$384.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$384.82
|
|
|
BIT SDK DR 1.7 4MM 61712
|
Facility
|
IP
|
$769.65
|
|
| Hospital Charge Code |
270610685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$115.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.45
|
|
|
BIT SDK DR ADJUSTABLE 876455
|
Facility
|
OP
|
$1,364.85
|
|
| Hospital Charge Code |
270618016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$177.43 |
| Max. Negotiated Rate |
$682.42 |
| Rate for Payer: Aetna Commercial |
$409.45
|
| Rate for Payer: Aetna Medicare Advantage |
$409.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$348.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$348.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$348.04
|
| Rate for Payer: Cigna Commercial |
$682.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$177.43
|
| Rate for Payer: Oxford Commercial |
$682.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$682.42
|
|
|
BIT SDK DR ADJUSTABLE 876455
|
Facility
|
IP
|
$1,364.85
|
|
| Hospital Charge Code |
270618016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$204.73 |
| Max. Negotiated Rate |
$204.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.73
|
|
|
BIT SDK DR TRIFLAT 13MM 876443
|
Facility
|
IP
|
$1,280.85
|
|
| Hospital Charge Code |
270614732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.13 |
| Max. Negotiated Rate |
$192.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$192.13
|
|
|
BIT SDK DR TRIFLAT 13MM 876443
|
Facility
|
OP
|
$1,280.85
|
|
| Hospital Charge Code |
270614732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.51 |
| Max. Negotiated Rate |
$640.42 |
| Rate for Payer: Aetna Commercial |
$384.25
|
| Rate for Payer: Aetna Medicare Advantage |
$384.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$326.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$326.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$326.62
|
| Rate for Payer: Cigna Commercial |
$640.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$166.51
|
| Rate for Payer: Oxford Commercial |
$640.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$192.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$640.42
|
|
|
BIT SYN DR 1.1MM 317.16
|
Facility
|
OP
|
$629.65
|
|
| Hospital Charge Code |
270619573
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.85 |
| Max. Negotiated Rate |
$314.82 |
| Rate for Payer: Aetna Commercial |
$188.90
|
| Rate for Payer: Aetna Medicare Advantage |
$188.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.56
|
| Rate for Payer: Cigna Commercial |
$314.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$81.85
|
| Rate for Payer: Oxford Commercial |
$314.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$314.82
|
|
|
BIT SYN DR 1.1MM 317.16
|
Facility
|
IP
|
$629.65
|
|
| Hospital Charge Code |
270619573
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.45 |
| Max. Negotiated Rate |
$94.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.45
|
|
|
BIT SYN DR 1 X 4 316.446
|
Facility
|
IP
|
$634.45
|
|
| Hospital Charge Code |
270617343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$95.17 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.17
|
|
|
BIT SYN DR 1 X 4 316.446
|
Facility
|
OP
|
$634.45
|
|
| Hospital Charge Code |
270617343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$82.48 |
| Max. Negotiated Rate |
$317.23 |
| Rate for Payer: Aetna Commercial |
$190.34
|
| Rate for Payer: Aetna Medicare Advantage |
$190.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$161.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$161.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$161.78
|
| Rate for Payer: Cigna Commercial |
$317.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.48
|
| Rate for Payer: Oxford Commercial |
$317.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$317.23
|
|