|
BLADE BMT SAW 516055
|
Facility
|
OP
|
$652.00
|
|
| Hospital Charge Code |
270617366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.76 |
| Max. Negotiated Rate |
$326.00 |
| Rate for Payer: Aetna Commercial |
$195.60
|
| Rate for Payer: Aetna Medicare Advantage |
$195.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$166.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$166.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$166.26
|
| Rate for Payer: Cigna Commercial |
$326.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.76
|
| Rate for Payer: Oxford Commercial |
$326.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$326.00
|
|
|
BLADE BMT SAW 516055
|
Facility
|
IP
|
$652.00
|
|
| Hospital Charge Code |
270617366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$97.80 |
| Max. Negotiated Rate |
$97.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.80
|
|
|
BLADE BONE SERRATED 20MM
|
Facility
|
OP
|
$2,025.00
|
|
| Hospital Charge Code |
270663193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.25 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$607.50
|
| Rate for Payer: Aetna Medicare Advantage |
$607.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.38
|
| Rate for Payer: Cigna Commercial |
$1,012.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$263.25
|
| Rate for Payer: Oxford Commercial |
$1,012.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,012.50
|
|
|
BLADE BONE SERRATED 20MM
|
Facility
|
IP
|
$2,025.00
|
|
| Hospital Charge Code |
270663193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
BLADE CAPSULE 4MM
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270679828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.75 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.75
|
| Rate for Payer: Oxford Commercial |
$487.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.50
|
|
|
BLADE CAPSULE 4MM
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270679828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
BLADE CARBIDE PUNCH
|
Facility
|
OP
|
$3,375.00
|
|
| Hospital Charge Code |
270680027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$438.75 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Aetna Commercial |
$1,012.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,012.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$860.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$860.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$860.62
|
| Rate for Payer: Cigna Commercial |
$1,687.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$438.75
|
| Rate for Payer: Oxford Commercial |
$1,687.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$506.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,687.50
|
|
|
BLADE CARBIDE PUNCH
|
Facility
|
IP
|
$3,375.00
|
|
| Hospital Charge Code |
270680027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$506.25 |
| Max. Negotiated Rate |
$506.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$506.25
|
|
|
BLADE CARRIGUE WEIGHTED VAG 31
|
Facility
|
IP
|
$718.20
|
|
| Hospital Charge Code |
270666999
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$107.73 |
| Max. Negotiated Rate |
$107.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.73
|
|
|
BLADE CARRIGUE WEIGHTED VAG 31
|
Facility
|
OP
|
$718.20
|
|
| Hospital Charge Code |
270666999
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.37 |
| Max. Negotiated Rate |
$359.10 |
| Rate for Payer: Aetna Commercial |
$215.46
|
| Rate for Payer: Aetna Medicare Advantage |
$215.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$183.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$183.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$183.14
|
| Rate for Payer: Cigna Commercial |
$359.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.37
|
| Rate for Payer: Oxford Commercial |
$359.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$359.10
|
|
|
BLADE CAST CUTTER
|
Facility
|
IP
|
$170.00
|
|
| Hospital Charge Code |
270665525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.50
|
|
|
BLADE CAST CUTTER
|
Facility
|
OP
|
$170.00
|
|
| Hospital Charge Code |
270665525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare Advantage |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.35
|
| Rate for Payer: Cigna Commercial |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.10
|
| Rate for Payer: Oxford Commercial |
$85.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.00
|
|
|
BLADE CHANNELED KING VISION
|
Facility
|
IP
|
$127.85
|
|
| Hospital Charge Code |
270676846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$19.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.18
|
|
|
BLADE CHANNELED KING VISION
|
Facility
|
OP
|
$127.85
|
|
| Hospital Charge Code |
270676846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.62 |
| Max. Negotiated Rate |
$63.92 |
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Medicare Advantage |
$38.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.60
|
| Rate for Payer: Cigna Commercial |
$63.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.62
|
| Rate for Payer: Oxford Commercial |
$63.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.92
|
|
|
BLADE CHISEL
|
Facility
|
IP
|
$3,500.00
|
|
| Hospital Charge Code |
270679897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
|
|
BLADE CHISEL
|
Facility
|
OP
|
$3,500.00
|
|
| Hospital Charge Code |
270686878
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.00 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,050.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$892.50
|
| Rate for Payer: Cigna Commercial |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$455.00
|
| Rate for Payer: Oxford Commercial |
$1,750.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,750.00
|
|
|
BLADE CHISEL
|
Facility
|
OP
|
$3,500.00
|
|
| Hospital Charge Code |
270679897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.00 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,050.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$892.50
|
| Rate for Payer: Cigna Commercial |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$455.00
|
| Rate for Payer: Oxford Commercial |
$1,750.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,750.00
|
|
|
BLADE CHISEL
|
Facility
|
IP
|
$3,500.00
|
|
| Hospital Charge Code |
270686878
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
|
|
BLADE CHISEL
|
Facility
|
IP
|
$3,500.00
|
|
| Hospital Charge Code |
270686880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
|
|
BLADE CHISEL
|
Facility
|
OP
|
$3,500.00
|
|
| Hospital Charge Code |
270686880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.00 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,050.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$892.50
|
| Rate for Payer: Cigna Commercial |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$455.00
|
| Rate for Payer: Oxford Commercial |
$1,750.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,750.00
|
|
|
BLADE CHISEL #62
|
Facility
|
OP
|
$8.75
|
|
| Hospital Charge Code |
270640380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$4.38 |
| Rate for Payer: Aetna Commercial |
$2.62
|
| Rate for Payer: Aetna Medicare Advantage |
$2.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.23
|
| Rate for Payer: Cigna Commercial |
$4.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.14
|
| Rate for Payer: Oxford Commercial |
$4.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.38
|
|
|
BLADE CHISEL #62
|
Facility
|
IP
|
$8.75
|
|
| Hospital Charge Code |
270640380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$1.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.31
|
|
|
BLADE COATED EDGE
|
Facility
|
OP
|
$1,678.90
|
|
| Hospital Charge Code |
270657388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$218.26 |
| Max. Negotiated Rate |
$839.45 |
| Rate for Payer: Aetna Commercial |
$503.67
|
| Rate for Payer: Aetna Medicare Advantage |
$503.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$428.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$428.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$428.12
|
| Rate for Payer: Cigna Commercial |
$839.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$218.26
|
| Rate for Payer: Oxford Commercial |
$839.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$251.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$839.45
|
|
|
BLADE COATED EDGE
|
Facility
|
IP
|
$1,678.90
|
|
| Hospital Charge Code |
270657388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.84 |
| Max. Negotiated Rate |
$251.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$251.84
|
|
|
BLADE COBB ELEV 13MM 11 IN
|
Facility
|
IP
|
$515.45
|
|
| Hospital Charge Code |
270678159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$77.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.32
|
|