|
BUR ACORN EXTRA LONG
|
Facility
|
IP
|
$580.75
|
|
| Hospital Charge Code |
270675302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$87.11 |
| Max. Negotiated Rate |
$87.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.11
|
|
|
BUR ACORN PRECISION 6MM
|
Facility
|
IP
|
$560.50
|
|
| Hospital Charge Code |
270672682
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.08 |
| Max. Negotiated Rate |
$84.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.08
|
|
|
BUR ACORN PRECISION 6MM
|
Facility
|
OP
|
$560.50
|
|
| Hospital Charge Code |
270672682
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.86 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Aetna Commercial |
$168.15
|
| Rate for Payer: Aetna Medicare Advantage |
$168.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$142.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$142.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$142.93
|
| Rate for Payer: Cigna Commercial |
$280.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.86
|
| Rate for Payer: Oxford Commercial |
$280.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$280.25
|
|
|
BUR ACORN SHORT
|
Facility
|
OP
|
$379.50
|
|
| Hospital Charge Code |
270675300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.34 |
| Max. Negotiated Rate |
$189.75 |
| Rate for Payer: Aetna Commercial |
$113.85
|
| Rate for Payer: Aetna Medicare Advantage |
$113.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$96.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$96.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$96.77
|
| Rate for Payer: Cigna Commercial |
$189.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.34
|
| Rate for Payer: Oxford Commercial |
$189.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$189.75
|
|
|
BUR ACORN SHORT
|
Facility
|
IP
|
$379.50
|
|
| Hospital Charge Code |
270675300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.92 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.92
|
|
|
BUR ANKLE
|
Facility
|
IP
|
$1,443.00
|
|
| Hospital Charge Code |
270677301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$216.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.45
|
|
|
BUR ANKLE
|
Facility
|
OP
|
$1,443.00
|
|
| Hospital Charge Code |
270677301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$187.59 |
| Max. Negotiated Rate |
$721.50 |
| Rate for Payer: Aetna Commercial |
$432.90
|
| Rate for Payer: Aetna Medicare Advantage |
$432.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$367.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$367.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$367.96
|
| Rate for Payer: Cigna Commercial |
$721.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$187.59
|
| Rate for Payer: Oxford Commercial |
$721.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$721.50
|
|
|
BUR ARTHOSCOPY 5.0cm OVAL
|
Facility
|
IP
|
$314.15
|
|
| Hospital Charge Code |
270674986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$47.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.12
|
|
|
BUR ARTHOSCOPY 5.0cm OVAL
|
Facility
|
OP
|
$314.15
|
|
| Hospital Charge Code |
270674986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.84 |
| Max. Negotiated Rate |
$157.07 |
| Rate for Payer: Aetna Commercial |
$94.25
|
| Rate for Payer: Aetna Medicare Advantage |
$94.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$80.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$80.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$80.11
|
| Rate for Payer: Cigna Commercial |
$157.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.84
|
| Rate for Payer: Oxford Commercial |
$157.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$157.07
|
|
|
BUR ARTHROSCOPY BARREL AGGRESS
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270656367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.70
|
| Rate for Payer: Oxford Commercial |
$95.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.00
|
|
|
BUR ARTHROSCOPY BARREL AGGRESS
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270656367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
BUR BARREL 12 FLUTE 4.0 HOLLOW
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270657598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
BUR BARREL 12 FLUTE 4.0 HOLLOW
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270657598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.70
|
| Rate for Payer: Oxford Commercial |
$95.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.00
|
|
|
BUR BARREL 4x10MM
|
Facility
|
IP
|
$98.70
|
|
| Hospital Charge Code |
270677700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$14.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.80
|
|
|
BUR BARREL 4x10MM
|
Facility
|
OP
|
$98.70
|
|
| Hospital Charge Code |
270677700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.83 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Aetna Commercial |
$29.61
|
| Rate for Payer: Aetna Medicare Advantage |
$29.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.17
|
| Rate for Payer: Cigna Commercial |
$49.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.83
|
| Rate for Payer: Oxford Commercial |
$49.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.35
|
|
|
BUR BARREL UNHOODED 4.0MM 6 FL
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270657599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
BUR BARREL UNHOODED 4.0MM 6 FL
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
270657599
|
|
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
|
|
|
BUR CARBIDE MATCH HEAD 3.0MM
|
Facility
|
OP
|
$1,376.05
|
|
| Hospital Charge Code |
270683791
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$178.89 |
| Max. Negotiated Rate |
$688.02 |
| Rate for Payer: Aetna Commercial |
$412.81
|
| Rate for Payer: Aetna Medicare Advantage |
$412.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$350.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$350.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$350.89
|
| Rate for Payer: Cigna Commercial |
$688.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.89
|
| Rate for Payer: Oxford Commercial |
$688.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$206.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$688.02
|
|
|
BUR CARBIDE MATCH HEAD 3.0MM
|
Facility
|
IP
|
$1,376.05
|
|
| Hospital Charge Code |
270683791
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$206.41 |
| Max. Negotiated Rate |
$206.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$206.41
|
|
|
BUR CRANIAL ROUTER TAP 2.3MM
|
Facility
|
OP
|
$392.85
|
|
| Hospital Charge Code |
270700148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.07 |
| Max. Negotiated Rate |
$196.43 |
| Rate for Payer: Aetna Commercial |
$117.86
|
| Rate for Payer: Aetna Medicare Advantage |
$117.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.18
|
| Rate for Payer: Cigna Commercial |
$196.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.07
|
| Rate for Payer: Oxford Commercial |
$196.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$196.43
|
|
|
BUR CRANIAL ROUTER TAP 2.3MM
|
Facility
|
IP
|
$392.85
|
|
| Hospital Charge Code |
270700148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.93 |
| Max. Negotiated Rate |
$58.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.93
|
|
|
BUR DIAMOND ELITE ROUND 2.0mm
|
Facility
|
IP
|
$607.55
|
|
| Hospital Charge Code |
270678593
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.13 |
| Max. Negotiated Rate |
$91.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.13
|
|
|
BUR DIAMOND ELITE ROUND 2.0mm
|
Facility
|
OP
|
$607.55
|
|
| Hospital Charge Code |
270678593
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.98 |
| Max. Negotiated Rate |
$303.77 |
| Rate for Payer: Aetna Commercial |
$182.26
|
| Rate for Payer: Aetna Medicare Advantage |
$182.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$154.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$154.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$154.93
|
| Rate for Payer: Cigna Commercial |
$303.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$78.98
|
| Rate for Payer: Oxford Commercial |
$303.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$303.77
|
|
|
BUR DIAMOND EXTRA COARSE 6.0
|
Facility
|
IP
|
$1,345.00
|
|
| Hospital Charge Code |
270694624
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$201.75 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$201.75
|
|
|
BUR DIAMOND EXTRA COARSE 6.0
|
Facility
|
OP
|
$1,345.00
|
|
| Hospital Charge Code |
270694624
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$672.50 |
| Rate for Payer: Aetna Commercial |
$403.50
|
| Rate for Payer: Aetna Medicare Advantage |
$403.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$342.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$342.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$342.98
|
| Rate for Payer: Cigna Commercial |
$672.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$174.85
|
| Rate for Payer: Oxford Commercial |
$672.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$201.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$672.50
|
|