|
BUR DRILL NEURO 3.0X3.8MM
|
Facility
|
OP
|
$375.00
|
|
| Hospital Charge Code |
270698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Aetna Medicare Advantage |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.62
|
| Rate for Payer: Cigna Commercial |
$187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.75
|
| Rate for Payer: Oxford Commercial |
$187.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$187.50
|
|
|
BUR EGG 5.0MM
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270673894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
BUR EGG 5.0MM
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270673894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
|
|
BUR EGG STANDARD 8 FLUTE 5.0MM
|
Facility
|
OP
|
$1,553.50
|
|
| Hospital Charge Code |
270658041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.03 |
| Max. Negotiated Rate |
$776.75 |
| Rate for Payer: Aetna Commercial |
$466.05
|
| Rate for Payer: Aetna Medicare Advantage |
$466.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$396.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$396.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$310.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$396.14
|
| Rate for Payer: Cigna Commercial |
$776.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$375.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.03
|
|
|
BUR EGG STANDARD 8 FLUTE 5.0MM
|
Facility
|
IP
|
$1,553.50
|
|
| Hospital Charge Code |
270658041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.03 |
| Max. Negotiated Rate |
$375.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$310.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$375.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.03
|
|
|
BUR ELECTRIC 5091-238 ZIM*****
|
Facility
|
IP
|
$168.00
|
|
| Hospital Charge Code |
1604909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.20
|
|
|
BUR ELECTRIC 5091-238 ZIM*****
|
Facility
|
OP
|
$168.00
|
|
| Hospital Charge Code |
1604909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$50.40
|
| Rate for Payer: Aetna Medicare Advantage |
$50.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.84
|
| Rate for Payer: Cigna Commercial |
$84.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.84
|
| Rate for Payer: Oxford Commercial |
$84.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$84.00
|
|
|
BUR FLUTED RND SFT TOUCH 2.0MM
|
Facility
|
OP
|
$607.50
|
|
| Hospital Charge Code |
270681017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.97 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$182.25
|
| Rate for Payer: Aetna Medicare Advantage |
$182.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$154.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$154.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$154.91
|
| Rate for Payer: Cigna Commercial |
$303.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$78.97
|
| Rate for Payer: Oxford Commercial |
$303.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$303.75
|
|
|
BUR FLUTED RND SFT TOUCH 2.0MM
|
Facility
|
IP
|
$607.50
|
|
| Hospital Charge Code |
270681017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.12 |
| Max. Negotiated Rate |
$91.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.12
|
|
|
BUR FLUTED RND SFT TOUCH 4MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270672677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$186.30
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.73
|
| Rate for Payer: Oxford Commercial |
$310.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$310.50
|
|
|
BUR FLUTED RND SFT TOUCH 4MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270672677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BUR FLUTED RND SFT TOUCH 5MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270669956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$186.30
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.73
|
| Rate for Payer: Oxford Commercial |
$310.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$310.50
|
|
|
BUR FLUTED RND SFT TOUCH 5MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270669956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BUR FLUTED RND SFT TOUCH 6MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270672680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$186.30
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.73
|
| Rate for Payer: Oxford Commercial |
$310.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$310.50
|
|
|
BUR FLUTED RND SFT TOUCH 6MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270672680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BURG SURG OVAL 5.5MM DIA 10MML
|
Facility
|
IP
|
$197.50
|
|
| Hospital Charge Code |
270655943
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$29.62 |
| Max. Negotiated Rate |
$29.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.62
|
|
|
BURG SURG OVAL 5.5MM DIA 10MML
|
Facility
|
OP
|
$197.50
|
|
| Hospital Charge Code |
270655943
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$98.75 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare Advantage |
$59.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.36
|
| Rate for Payer: Cigna Commercial |
$98.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.68
|
| Rate for Payer: Oxford Commercial |
$98.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$98.75
|
|
|
BUR GUARD LONG 00137501100
|
Facility
|
IP
|
$1,531.80
|
|
| Hospital Charge Code |
270647005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$229.77 |
| Max. Negotiated Rate |
$229.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$229.77
|
|
|
BUR GUARD LONG 00137501100
|
Facility
|
OP
|
$1,531.80
|
|
| Hospital Charge Code |
270647005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.13 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Aetna Commercial |
$459.54
|
| Rate for Payer: Aetna Medicare Advantage |
$459.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$390.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$390.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$390.61
|
| Rate for Payer: Cigna Commercial |
$765.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.13
|
| Rate for Payer: Oxford Commercial |
$765.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$229.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$765.90
|
|
|
BUR GUARD MEDIUM 00137501200
|
Facility
|
IP
|
$1,326.95
|
|
| Hospital Charge Code |
270647004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.04 |
| Max. Negotiated Rate |
$199.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$199.04
|
|
|
BUR GUARD MEDIUM 00137501200
|
Facility
|
OP
|
$1,326.95
|
|
| Hospital Charge Code |
270647004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.50 |
| Max. Negotiated Rate |
$663.48 |
| Rate for Payer: Aetna Commercial |
$398.08
|
| Rate for Payer: Aetna Medicare Advantage |
$398.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$338.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$338.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$338.37
|
| Rate for Payer: Cigna Commercial |
$663.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.50
|
| Rate for Payer: Oxford Commercial |
$663.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$199.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$663.48
|
|
|
BUR HOODED ABRASION SM JOINT
|
Facility
|
OP
|
$1,435.00
|
|
| Hospital Charge Code |
270658016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.25 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna Commercial |
$430.50
|
| Rate for Payer: Aetna Medicare Advantage |
$430.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$365.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$365.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$287.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$365.93
|
| Rate for Payer: Cigna Commercial |
$717.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$347.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.25
|
|
|
BUR HOODED ABRASION SM JOINT
|
Facility
|
IP
|
$1,435.00
|
|
| Hospital Charge Code |
270658016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.25 |
| Max. Negotiated Rate |
$347.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$287.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$347.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.25
|
|
|
BUR HOODED ABRS SM JOINT 3.0MM
|
Facility
|
IP
|
$1,435.00
|
|
| Hospital Charge Code |
270658021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.25 |
| Max. Negotiated Rate |
$347.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$287.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$347.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.25
|
|
|
BUR HOODED ABRS SM JOINT 3.0MM
|
Facility
|
OP
|
$1,435.00
|
|
| Hospital Charge Code |
270658021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.25 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna Commercial |
$430.50
|
| Rate for Payer: Aetna Medicare Advantage |
$430.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$365.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$365.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$287.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$365.93
|
| Rate for Payer: Cigna Commercial |
$717.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$347.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.25
|
|