|
BLADE SAW STERNUM 32MM
|
Facility
|
OP
|
$52.35
|
|
| Hospital Charge Code |
270662338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$26.18 |
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: Aetna Medicare Advantage |
$15.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.35
|
| Rate for Payer: Cigna Commercial |
$26.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.81
|
| Rate for Payer: Oxford Commercial |
$26.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.18
|
|
|
BLADE SAW STERNUM 32MM
|
Facility
|
IP
|
$52.35
|
|
| Hospital Charge Code |
270662338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.85 |
| Max. Negotiated Rate |
$7.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.85
|
|
|
BLADE SAW WIDE .5 INCH
|
Facility
|
OP
|
$1,665.00
|
|
| Hospital Charge Code |
270693696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Aetna Commercial |
$499.50
|
| Rate for Payer: Aetna Medicare Advantage |
$499.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.57
|
| Rate for Payer: Cigna Commercial |
$832.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$216.45
|
| Rate for Payer: Oxford Commercial |
$832.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$832.50
|
|
|
BLADE SAW WIDE .5 INCH
|
Facility
|
IP
|
$1,665.00
|
|
| Hospital Charge Code |
270693696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.75 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.75
|
|
|
BLADE SCALPEL 20MM STD
|
Facility
|
IP
|
$2,025.00
|
|
| Hospital Charge Code |
270684398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
BLADE SCALPEL 20MM STD
|
Facility
|
OP
|
$2,025.00
|
|
| Hospital Charge Code |
270684398
|
|
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 SCLERATOME MULTI-SIDED
|
Facility
|
OP
|
$52.30
|
|
| Hospital Charge Code |
270651004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$26.15 |
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Medicare Advantage |
$15.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.34
|
| Rate for Payer: Cigna Commercial |
$26.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.80
|
| Rate for Payer: Oxford Commercial |
$26.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.15
|
|
|
BLADE SCLERATOME MULTI-SIDED
|
Facility
|
IP
|
$52.30
|
|
| Hospital Charge Code |
270651004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$7.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.84
|
|
|
BLADE SCREWDRIVER 1.5/2.0mm
|
Facility
|
IP
|
$2,757.00
|
|
| Hospital Charge Code |
270656594
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$413.55 |
| Max. Negotiated Rate |
$413.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$413.55
|
|
|
BLADE SCREWDRIVER 1.5/2.0mm
|
Facility
|
OP
|
$2,757.00
|
|
| Hospital Charge Code |
270656594
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$358.41 |
| Max. Negotiated Rate |
$1,378.50 |
| Rate for Payer: Aetna Commercial |
$827.10
|
| Rate for Payer: Aetna Medicare Advantage |
$827.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$703.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$703.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$703.03
|
| Rate for Payer: Cigna Commercial |
$1,378.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$358.41
|
| Rate for Payer: Oxford Commercial |
$1,378.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$413.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,378.50
|
|
|
BLADES DISPOSABLE STERNUM SAW
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270657616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
BLADES DISPOSABLE STERNUM SAW
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
270657616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$60.00
|
| Rate for Payer: Aetna Medicare Advantage |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.00
|
| Rate for Payer: Cigna Commercial |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.00
|
| Rate for Payer: Oxford Commercial |
$100.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$100.00
|
|
|
BLADE SET E SHAPER
|
Facility
|
IP
|
$3,750.00
|
|
| Hospital Charge Code |
270670839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$562.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
BLADE SET E SHAPER
|
Facility
|
OP
|
$3,750.00
|
|
| Hospital Charge Code |
270670839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$487.50 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,125.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$956.25
|
| Rate for Payer: Cigna Commercial |
$1,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$487.50
|
| Rate for Payer: Oxford Commercial |
$1,875.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,875.00
|
|
|
BLADE SHARP HOOK 10CM
|
Facility
|
OP
|
$4,600.00
|
|
| Hospital Charge Code |
270610060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$598.00 |
| Max. Negotiated Rate |
$2,300.00 |
| Rate for Payer: Aetna Commercial |
$1,380.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,380.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,173.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,173.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,173.00
|
| Rate for Payer: Cigna Commercial |
$2,300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$598.00
|
| Rate for Payer: Oxford Commercial |
$2,300.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$690.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,300.00
|
|
|
BLADE SHARP HOOK 10CM
|
Facility
|
IP
|
$4,600.00
|
|
| Hospital Charge Code |
270610060
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.00 |
| Max. Negotiated Rate |
$690.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$690.00
|
|
|
BLADE SHAVER AGG 3.5 275534000
|
Facility
|
OP
|
$313.25
|
|
| Hospital Charge Code |
270633197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.72 |
| Max. Negotiated Rate |
$156.62 |
| Rate for Payer: Aetna Commercial |
$93.97
|
| Rate for Payer: Aetna Medicare Advantage |
$93.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.88
|
| Rate for Payer: Cigna Commercial |
$156.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.72
|
| Rate for Payer: Oxford Commercial |
$156.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.62
|
|
|
BLADE SHAVER AGG 3.5 275534000
|
Facility
|
IP
|
$313.25
|
|
| Hospital Charge Code |
270633197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$46.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.99
|
|
|
BLADE SHAVER FULL RAD 2MMX7CM
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270695939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$450.00
|
| Rate for Payer: Aetna Medicare Advantage |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Oxford Commercial |
$750.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$750.00
|
|
|
BLADE SHAVER FULL RAD 2MMX7CM
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270695939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
BLADE SHEATHED SNGL STR 2.5MM
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
270655983
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
BLADE SHEATHED SNGL STR 2.5MM
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
270655983
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$35.75 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$82.50
|
| Rate for Payer: Aetna Medicare Advantage |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.12
|
| Rate for Payer: Cigna Commercial |
$137.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.75
|
| Rate for Payer: Oxford Commercial |
$137.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.50
|
|
|
BLADE SHVR 4MM 11CML M4 ROTATE
|
Facility
|
IP
|
$1,520.00
|
|
| Hospital Charge Code |
270663279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$228.00 |
| Max. Negotiated Rate |
$228.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$228.00
|
|
|
BLADE SHVR 4MM 11CML M4 ROTATE
|
Facility
|
OP
|
$1,520.00
|
|
| Hospital Charge Code |
270663279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$197.60 |
| Max. Negotiated Rate |
$760.00 |
| Rate for Payer: Aetna Commercial |
$456.00
|
| Rate for Payer: Aetna Medicare Advantage |
$456.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.60
|
| Rate for Payer: Cigna Commercial |
$760.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$197.60
|
| Rate for Payer: Oxford Commercial |
$760.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$228.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$760.00
|
|
|
BLADE SIDEWINER ICW
|
Facility
|
IP
|
$4,462.00
|
|
| Hospital Charge Code |
270688039
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$669.30 |
| Max. Negotiated Rate |
$669.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$669.30
|
|