|
ANCHOR ALPHAVENT 4.75 MM BIOCO
|
Facility
|
IP
|
$3,000.00
|
|
| Hospital Charge Code |
270701806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$726.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$726.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$450.00
|
|
|
ANCHOR ALPHAVENT 4.75 MM PEEK
|
Facility
|
IP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$487.50 |
| Max. Negotiated Rate |
$786.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
|
|
ANCHOR ALPHAVENT 4.75 MM PEEK
|
Facility
|
OP
|
$3,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.30 |
| Max. Negotiated Rate |
$1,625.00 |
| Rate for Payer: Aetna Commercial |
$1,235.00
|
| Rate for Payer: Aetna Medicare Advantage |
$975.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$828.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$828.75
|
| Rate for Payer: Cigna Commercial |
$1,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$487.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$102.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$92.30
|
|
|
ANCHOR BIOSUTURE TAK 3x14
|
Facility
|
IP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$393.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
|
|
ANCHOR BIOSUTURE TAK 3x14
|
Facility
|
OP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$46.15 |
| Max. Negotiated Rate |
$812.50 |
| Rate for Payer: Aetna Commercial |
$617.50
|
| Rate for Payer: Aetna Medicare Advantage |
$487.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$414.38
|
| Rate for Payer: Cigna Commercial |
$812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.15
|
|
|
ANCHOR CERVICAL MEDIUM AIS-C
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270697996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$1,210.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
|
|
ANCHOR CERVICAL MEDIUM AIS-C
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270697996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.00 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$1,900.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,275.00
|
| Rate for Payer: Cigna Commercial |
$2,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$158.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$142.00
|
|
|
ANCHOR COALITION MIS 11MM
|
Facility
|
IP
|
$3,020.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270694204
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.00 |
| Max. Negotiated Rate |
$730.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$604.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$730.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.00
|
|
|
ANCHOR COALITION MIS 11MM
|
Facility
|
OP
|
$3,020.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270694204
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.77 |
| Max. Negotiated Rate |
$1,510.00 |
| Rate for Payer: Aetna Commercial |
$1,147.60
|
| Rate for Payer: Aetna Medicare Advantage |
$906.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$770.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$770.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$604.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$770.10
|
| Rate for Payer: Cigna Commercial |
$1,510.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$730.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$95.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$85.77
|
|
|
ANCHOR COALITION MIS 13MM
|
Facility
|
IP
|
$3,020.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.00 |
| Max. Negotiated Rate |
$730.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$604.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$730.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.00
|
|
|
ANCHOR COALITION MIS 13MM
|
Facility
|
OP
|
$3,020.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.77 |
| Max. Negotiated Rate |
$1,510.00 |
| Rate for Payer: Aetna Commercial |
$1,147.60
|
| Rate for Payer: Aetna Medicare Advantage |
$906.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$770.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$770.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$604.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$770.10
|
| Rate for Payer: Cigna Commercial |
$1,510.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$730.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$95.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$85.77
|
|
|
ANCHOR DRILL GUIDE GRAFT
|
Facility
|
OP
|
$14,375.00
|
|
| Hospital Charge Code |
270691003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$408.25 |
| Max. Negotiated Rate |
$7,187.50 |
| Rate for Payer: Aetna Commercial |
$5,462.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,312.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,665.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,665.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,665.62
|
| Rate for Payer: Cigna Commercial |
$7,187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,737.50
|
| Rate for Payer: Oxford Commercial |
$2,875.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,156.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,875.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$454.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$408.25
|
|
|
ANCHOR DRILL GUIDE GRAFT
|
Facility
|
IP
|
$14,375.00
|
|
| Hospital Charge Code |
270691003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,156.25 |
| Max. Negotiated Rate |
$2,156.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,156.25
|
|
|
ANCHOR FAST
|
Facility
|
OP
|
$41.93
|
|
| Hospital Charge Code |
270648592
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$20.96 |
| Rate for Payer: Aetna Commercial |
$15.93
|
| Rate for Payer: Aetna Medicare Advantage |
$12.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.69
|
| Rate for Payer: Cigna Commercial |
$20.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.90
|
| Rate for Payer: Oxford Commercial |
$8.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.39
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.19
|
|
|
ANCHOR FAST
|
Facility
|
IP
|
$41.93
|
|
| Hospital Charge Code |
270648592
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$6.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.29
|
|
|
ANCHOR FIBERLINK
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$104.50
|
| 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) NJ Health |
$55.00
|
| 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 |
$66.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.81
|
|
|
ANCHOR FIBERLINK
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$66.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
ANCHOR FIBERLOCK SUSPENSN SYS
|
Facility
|
IP
|
$8,641.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,296.26 |
| Max. Negotiated Rate |
$2,091.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,728.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,091.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,296.26
|
|
|
ANCHOR FIBERLOCK SUSPENSN SYS
|
Facility
|
OP
|
$8,641.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$245.43 |
| Max. Negotiated Rate |
$4,320.88 |
| Rate for Payer: Aetna Commercial |
$3,283.86
|
| Rate for Payer: Aetna Medicare Advantage |
$2,592.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,203.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,203.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,728.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,203.65
|
| Rate for Payer: Cigna Commercial |
$4,320.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,091.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,296.26
|
| Rate for Payer: UnitedHealthcare Community & State |
$273.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$245.43
|
|
|
ANCHOR GRAVITY SUTURE
|
Facility
|
IP
|
$2,020.00
|
|
| Hospital Charge Code |
270684835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.00 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.00
|
|
|
ANCHOR GRAVITY SUTURE
|
Facility
|
OP
|
$2,020.00
|
|
| Hospital Charge Code |
270684835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.37 |
| Max. Negotiated Rate |
$1,010.00 |
| Rate for Payer: Aetna Commercial |
$767.60
|
| Rate for Payer: Aetna Medicare Advantage |
$606.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$515.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$515.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$515.10
|
| Rate for Payer: Cigna Commercial |
$1,010.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$525.20
|
| Rate for Payer: Oxford Commercial |
$404.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$404.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.37
|
|
|
ANCHOR HEALICOIL RSB SA 4.75MM
|
Facility
|
OP
|
$3,875.00
|
|
| Hospital Charge Code |
270682200
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.05 |
| Max. Negotiated Rate |
$1,937.50 |
| Rate for Payer: Aetna Commercial |
$1,472.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,162.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$988.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$988.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$988.12
|
| Rate for Payer: Cigna Commercial |
$1,937.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,007.50
|
| Rate for Payer: Oxford Commercial |
$775.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$581.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$775.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$110.05
|
|
|
ANCHOR HEALICOIL RSB SA 4.75MM
|
Facility
|
IP
|
$3,875.00
|
|
| Hospital Charge Code |
270682200
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$581.25 |
| Max. Negotiated Rate |
$581.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$581.25
|
|
|
ANCHOR HEALIX AD
|
Facility
|
IP
|
$2,565.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$384.75 |
| Max. Negotiated Rate |
$620.73 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$513.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$620.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$384.75
|
|
|
ANCHOR HEALIX AD
|
Facility
|
OP
|
$2,565.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$1,282.50 |
| Rate for Payer: Aetna Commercial |
$974.70
|
| Rate for Payer: Aetna Medicare Advantage |
$769.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$654.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$654.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$654.08
|
| Rate for Payer: Cigna Commercial |
$1,282.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$620.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$384.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$81.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$72.85
|
|