|
BLADE BARREL BUR 5.5MM
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270657600
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
BLADE BEAVER #57
|
Facility
|
IP
|
$153.65
|
|
| Hospital Charge Code |
270600187
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.05 |
| Max. Negotiated Rate |
$23.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.05
|
|
|
BLADE BEAVER #57
|
Facility
|
OP
|
$153.65
|
|
| Hospital Charge Code |
270600187
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$76.83 |
| Rate for Payer: Aetna Commercial |
$46.09
|
| Rate for Payer: Aetna Medicare Advantage |
$46.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.18
|
| Rate for Payer: Cigna Commercial |
$76.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.97
|
| Rate for Payer: Oxford Commercial |
$76.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.83
|
|
|
BLADE BEAVER #64
|
Facility
|
OP
|
$9.58
|
|
| Hospital Charge Code |
270600364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$4.79 |
| Rate for Payer: Aetna Commercial |
$2.87
|
| Rate for Payer: Aetna Medicare Advantage |
$2.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.44
|
| Rate for Payer: Cigna Commercial |
$4.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.25
|
| Rate for Payer: Oxford Commercial |
$4.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.79
|
|
|
BLADE BEAVER #64
|
Facility
|
IP
|
$9.58
|
|
| Hospital Charge Code |
270600364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$1.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.44
|
|
|
BLADE BEAVER #71 MYRING
|
Facility
|
IP
|
$402.45
|
|
| Hospital Charge Code |
270060150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.37 |
| Max. Negotiated Rate |
$60.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.37
|
|
|
BLADE BEAVER #71 MYRING
|
Facility
|
OP
|
$402.45
|
|
| Hospital Charge Code |
270060150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.32 |
| Max. Negotiated Rate |
$201.22 |
| Rate for Payer: Aetna Commercial |
$120.73
|
| Rate for Payer: Aetna Medicare Advantage |
$120.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.62
|
| Rate for Payer: Cigna Commercial |
$201.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$52.32
|
| Rate for Payer: Oxford Commercial |
$201.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$201.22
|
|
|
BLADE BEAVER MINI #61
|
Facility
|
OP
|
$6.27
|
|
| Hospital Charge Code |
270600363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$3.13 |
| Rate for Payer: Aetna Commercial |
$1.88
|
| Rate for Payer: Aetna Medicare Advantage |
$1.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.60
|
| Rate for Payer: Cigna Commercial |
$3.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.82
|
| Rate for Payer: Oxford Commercial |
$3.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.13
|
|
|
BLADE BEAVER MINI #61
|
Facility
|
IP
|
$6.27
|
|
| Hospital Charge Code |
270600363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.94 |
| Max. Negotiated Rate |
$0.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.94
|
|
|
BLADE BEAVER MYRING 377120
|
Facility
|
OP
|
$39.25
|
|
| Hospital Charge Code |
270618117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$19.62 |
| Rate for Payer: Aetna Commercial |
$11.78
|
| Rate for Payer: Aetna Medicare Advantage |
$11.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.01
|
| Rate for Payer: Cigna Commercial |
$19.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.10
|
| Rate for Payer: Oxford Commercial |
$19.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.62
|
|
|
BLADE BEAVER MYRING 377120
|
Facility
|
IP
|
$39.25
|
|
| Hospital Charge Code |
270618117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$5.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
|
|
BLADE BLUN SHEATH &TUBE 20MM
|
Facility
|
OP
|
$3,775.50
|
|
| Hospital Charge Code |
270692974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$490.81 |
| Max. Negotiated Rate |
$1,887.75 |
| Rate for Payer: Aetna Commercial |
$1,132.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1,132.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$962.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$962.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$962.75
|
| Rate for Payer: Cigna Commercial |
$1,887.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$490.81
|
| Rate for Payer: Oxford Commercial |
$1,887.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$566.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,887.75
|
|
|
BLADE BLUN SHEATH &TUBE 20MM
|
Facility
|
IP
|
$3,775.50
|
|
| Hospital Charge Code |
270692974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$566.33 |
| Max. Negotiated Rate |
$566.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$566.33
|
|
|
BLADE BLUNT 20MM AND TUBING
|
Facility
|
OP
|
$2,775.00
|
|
| Hospital Charge Code |
270693211
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$360.75 |
| Max. Negotiated Rate |
$1,387.50 |
| Rate for Payer: Aetna Commercial |
$832.50
|
| Rate for Payer: Aetna Medicare Advantage |
$832.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$707.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$707.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$707.62
|
| Rate for Payer: Cigna Commercial |
$1,387.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$360.75
|
| Rate for Payer: Oxford Commercial |
$1,387.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$416.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,387.50
|
|
|
BLADE BLUNT 20MM AND TUBING
|
Facility
|
IP
|
$2,775.00
|
|
| Hospital Charge Code |
270693211
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$416.25 |
| Max. Negotiated Rate |
$416.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$416.25
|
|
|
BLADE BLUNT MIS 10MM
|
Facility
|
OP
|
$3,775.90
|
|
| Hospital Charge Code |
270694731
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$490.87 |
| Max. Negotiated Rate |
$1,887.95 |
| Rate for Payer: Aetna Commercial |
$1,132.77
|
| Rate for Payer: Aetna Medicare Advantage |
$1,132.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$962.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$962.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$962.85
|
| Rate for Payer: Cigna Commercial |
$1,887.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$490.87
|
| Rate for Payer: Oxford Commercial |
$1,887.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$566.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,887.95
|
|
|
BLADE BLUNT MIS 10MM
|
Facility
|
IP
|
$3,775.90
|
|
| Hospital Charge Code |
270694731
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$566.38 |
| Max. Negotiated Rate |
$566.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$566.38
|
|
|
BLADE BLUNT-S 50MM
|
Facility
|
OP
|
$2,525.00
|
|
| Hospital Charge Code |
270697369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$328.25 |
| Max. Negotiated Rate |
$1,262.50 |
| Rate for Payer: Aetna Commercial |
$757.50
|
| Rate for Payer: Aetna Medicare Advantage |
$757.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$643.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$643.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$643.88
|
| Rate for Payer: Cigna Commercial |
$1,262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$328.25
|
| Rate for Payer: Oxford Commercial |
$1,262.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$378.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,262.50
|
|
|
BLADE BLUNT-S 50MM
|
Facility
|
IP
|
$2,525.00
|
|
| Hospital Charge Code |
270697369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.75 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$378.75
|
|
|
BLADE BMT DIAMOND V 516050
|
Facility
|
OP
|
$655.25
|
|
| Hospital Charge Code |
270613047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.18 |
| Max. Negotiated Rate |
$327.62 |
| Rate for Payer: Aetna Commercial |
$196.57
|
| Rate for Payer: Aetna Medicare Advantage |
$196.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$167.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$167.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$167.09
|
| Rate for Payer: Cigna Commercial |
$327.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.18
|
| Rate for Payer: Oxford Commercial |
$327.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$98.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$327.62
|
|
|
BLADE BMT DIAMOND V 516050
|
Facility
|
IP
|
$655.25
|
|
| Hospital Charge Code |
270613047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.29 |
| Max. Negotiated Rate |
$98.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$98.29
|
|
|
BLADE BMT DIAMOND V 516053
|
Facility
|
IP
|
$869.65
|
|
| Hospital Charge Code |
270609690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.45 |
| Max. Negotiated Rate |
$130.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.45
|
|
|
BLADE BMT DIAMOND V 516053
|
Facility
|
OP
|
$869.65
|
|
| Hospital Charge Code |
270609690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.05 |
| Max. Negotiated Rate |
$434.82 |
| Rate for Payer: Aetna Commercial |
$260.89
|
| Rate for Payer: Aetna Medicare Advantage |
$260.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.76
|
| Rate for Payer: Cigna Commercial |
$434.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.05
|
| Rate for Payer: Oxford Commercial |
$434.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$434.82
|
|
|
BLADE BMT OSCILL SAW 506053
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270606318
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
BLADE BMT OSCILL SAW 506053
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270606318
|
|
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
|
|