|
KNIFE LIF
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270702572
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$570.00
|
| 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) NJ Health |
$300.00
|
| 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 |
$363.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
KNIFE MICROSURGERY
|
Facility
|
OP
|
$204.15
|
|
| Hospital Charge Code |
270675324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$102.08 |
| Rate for Payer: Aetna Commercial |
$77.58
|
| Rate for Payer: Aetna Medicare Advantage |
$61.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.06
|
| Rate for Payer: Cigna Commercial |
$102.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.08
|
| Rate for Payer: Oxford Commercial |
$40.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.83
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.80
|
|
|
KNIFE MICROSURGERY
|
Facility
|
IP
|
$204.15
|
|
| Hospital Charge Code |
270675324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.62 |
| Max. Negotiated Rate |
$30.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.62
|
|
|
KNIFE MICRO-UNITOME 22.5
|
Facility
|
OP
|
$71.00
|
|
| Hospital Charge Code |
270335133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$35.50 |
| Rate for Payer: Aetna Commercial |
$26.98
|
| Rate for Payer: Aetna Medicare Advantage |
$21.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.11
|
| Rate for Payer: Cigna Commercial |
$35.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.46
|
| Rate for Payer: Oxford Commercial |
$14.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.02
|
|
|
KNIFE MICRO-UNITOME 22.5
|
Facility
|
IP
|
$71.00
|
|
| Hospital Charge Code |
270335133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$10.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
|
|
KNIFE MTK ACL GRAFT 10 200701
|
Facility
|
OP
|
$950.00
|
|
| Hospital Charge Code |
270625067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Aetna Commercial |
$361.00
|
| Rate for Payer: Aetna Medicare Advantage |
$285.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$242.25
|
| Rate for Payer: Cigna Commercial |
$475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.00
|
| Rate for Payer: Oxford Commercial |
$190.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.98
|
|
|
KNIFE MTK ACL GRAFT 10 200701
|
Facility
|
IP
|
$950.00
|
|
| Hospital Charge Code |
270625067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
|
|
KNIFE OPHTHALMIC CURVED 6/BX
|
Facility
|
IP
|
$111.65
|
|
| Hospital Charge Code |
270650725
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$16.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.75
|
|
|
KNIFE OPHTHALMIC CURVED 6/BX
|
Facility
|
OP
|
$111.65
|
|
| Hospital Charge Code |
270650725
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$55.83 |
| Rate for Payer: Aetna Commercial |
$42.43
|
| Rate for Payer: Aetna Medicare Advantage |
$33.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.47
|
| Rate for Payer: Cigna Commercial |
$55.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.03
|
| Rate for Payer: Oxford Commercial |
$22.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.33
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.17
|
|
|
KNIFE OPHTHALMIC SLIT 2.4MM AN
|
Facility
|
IP
|
$232.75
|
|
| Hospital Charge Code |
270655842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.91 |
| Max. Negotiated Rate |
$34.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.91
|
|
|
KNIFE OPHTHALMIC SLIT 2.4MM AN
|
Facility
|
OP
|
$232.75
|
|
| Hospital Charge Code |
270655842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$116.38 |
| Rate for Payer: Aetna Commercial |
$88.44
|
| Rate for Payer: Aetna Medicare Advantage |
$69.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.35
|
| Rate for Payer: Cigna Commercial |
$116.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.52
|
| Rate for Payer: Oxford Commercial |
$46.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.61
|
|
|
KNIFE OPTHALMIC 15 DEGREE
|
Facility
|
IP
|
$62.00
|
|
| Hospital Charge Code |
270335131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$9.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.30
|
|
|
KNIFE OPTHALMIC 15 DEGREE
|
Facility
|
OP
|
$62.00
|
|
| Hospital Charge Code |
270335131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.76 |
| Max. Negotiated Rate |
$31.00 |
| Rate for Payer: Aetna Commercial |
$23.56
|
| Rate for Payer: Aetna Medicare Advantage |
$18.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.81
|
| Rate for Payer: Cigna Commercial |
$31.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.12
|
| Rate for Payer: Oxford Commercial |
$12.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.76
|
|
|
KNIFE OPTHALMIC 57
|
Facility
|
OP
|
$203.00
|
|
| Hospital Charge Code |
270335134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.77 |
| Max. Negotiated Rate |
$101.50 |
| Rate for Payer: Aetna Commercial |
$77.14
|
| Rate for Payer: Aetna Medicare Advantage |
$60.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.77
|
| Rate for Payer: Cigna Commercial |
$101.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$52.78
|
| Rate for Payer: Oxford Commercial |
$40.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.77
|
|
|
KNIFE OPTHALMIC 57
|
Facility
|
IP
|
$203.00
|
|
| Hospital Charge Code |
270335134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.45 |
| Max. Negotiated Rate |
$30.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
|
|
KNIFE PHACO SLIT PAK 3.2 MM
|
Facility
|
IP
|
$394.90
|
|
| Hospital Charge Code |
270654249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$59.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
|
|
KNIFE PHACO SLIT PAK 3.2 MM
|
Facility
|
OP
|
$394.90
|
|
| Hospital Charge Code |
270654249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$197.45 |
| Rate for Payer: Aetna Commercial |
$150.06
|
| Rate for Payer: Aetna Medicare Advantage |
$118.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.70
|
| Rate for Payer: Cigna Commercial |
$197.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.67
|
| Rate for Payer: Oxford Commercial |
$78.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$78.98
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.22
|
|
|
KNIFE SACHSE COLD STR
|
Facility
|
OP
|
$811.97
|
|
| Hospital Charge Code |
270644707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.06 |
| Max. Negotiated Rate |
$405.99 |
| Rate for Payer: Aetna Commercial |
$308.55
|
| Rate for Payer: Aetna Medicare Advantage |
$243.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.05
|
| Rate for Payer: Cigna Commercial |
$405.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$211.11
|
| Rate for Payer: Oxford Commercial |
$162.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$162.39
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.06
|
|
|
KNIFE SACHSE COLD STR
|
Facility
|
IP
|
$811.97
|
|
| Hospital Charge Code |
270644707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$121.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.80
|
|
|
KNIFE SATIN CRESCENT ANGL
|
Facility
|
OP
|
$669.90
|
|
| Hospital Charge Code |
270655245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.03 |
| Max. Negotiated Rate |
$334.95 |
| Rate for Payer: Aetna Commercial |
$254.56
|
| Rate for Payer: Aetna Medicare Advantage |
$200.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.82
|
| Rate for Payer: Cigna Commercial |
$334.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$174.17
|
| Rate for Payer: Oxford Commercial |
$133.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$133.98
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.03
|
|
|
KNIFE SATIN CRESCENT ANGL
|
Facility
|
IP
|
$669.90
|
|
| Hospital Charge Code |
270655245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.48 |
| Max. Negotiated Rate |
$100.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.48
|
|
|
KNIFE STORZ COLD
|
Facility
|
IP
|
$556.00
|
|
| Hospital Charge Code |
270335143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.40 |
| Max. Negotiated Rate |
$83.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.40
|
|
|
KNIFE STORZ COLD
|
Facility
|
OP
|
$556.00
|
|
| Hospital Charge Code |
270335143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$278.00 |
| Rate for Payer: Aetna Commercial |
$211.28
|
| Rate for Payer: Aetna Medicare Advantage |
$166.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$141.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$141.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$141.78
|
| Rate for Payer: Cigna Commercial |
$278.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.56
|
| Rate for Payer: Oxford Commercial |
$111.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$111.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
KNIFE STRAIGHT COLD
|
Facility
|
IP
|
$921.00
|
|
| Hospital Charge Code |
270335281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.15 |
| Max. Negotiated Rate |
$138.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.15
|
|
|
KNIFE STRAIGHT COLD
|
Facility
|
OP
|
$921.00
|
|
| Hospital Charge Code |
270335281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.16 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$349.98
|
| Rate for Payer: Aetna Medicare Advantage |
$276.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$234.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$234.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$234.85
|
| Rate for Payer: Cigna Commercial |
$460.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$239.46
|
| Rate for Payer: Oxford Commercial |
$184.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$184.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.16
|
|