|
REAGENT BOND ORACLE HER2 IHC
|
Facility
|
IP
|
$12,330.30
|
|
| Hospital Charge Code |
270676051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,849.55 |
| Max. Negotiated Rate |
$1,849.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,849.55
|
|
|
REAGENT BOND ORACLE HER2 IHC
|
Facility
|
OP
|
$12,330.30
|
|
| Hospital Charge Code |
270676051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$350.18 |
| Max. Negotiated Rate |
$6,165.15 |
| Rate for Payer: Aetna Commercial |
$4,685.51
|
| Rate for Payer: Aetna Medicare Advantage |
$3,699.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,144.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,144.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,144.23
|
| Rate for Payer: Cigna Commercial |
$6,165.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,205.88
|
| Rate for Payer: Oxford Commercial |
$2,466.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,849.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,466.06
|
| Rate for Payer: UnitedHealthcare Community & State |
$389.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$350.18
|
|
|
REAMER
|
Facility
|
IP
|
$1,107.55
|
|
| Hospital Charge Code |
270688888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.13 |
| Max. Negotiated Rate |
$166.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.13
|
|
|
REAMER
|
Facility
|
OP
|
$1,107.55
|
|
| Hospital Charge Code |
270688888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.45 |
| Max. Negotiated Rate |
$553.77 |
| Rate for Payer: Aetna Commercial |
$420.87
|
| Rate for Payer: Aetna Medicare Advantage |
$332.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$282.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$282.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$282.43
|
| Rate for Payer: Cigna Commercial |
$553.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$287.96
|
| Rate for Payer: Oxford Commercial |
$221.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$221.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.45
|
|
|
REAMER 14 MM CORING COLLARED
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270688460
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER 14 MM CORING COLLARED
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270688460
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.11 |
| Max. Negotiated Rate |
$512.50 |
| Rate for Payer: Aetna Commercial |
$389.50
|
| Rate for Payer: Aetna Medicare Advantage |
$307.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$261.38
|
| Rate for Payer: Cigna Commercial |
$512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.50
|
| Rate for Payer: Oxford Commercial |
$205.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$205.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.11
|
|
|
REAMER 15MM
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270680646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$253.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.69
|
|
|
REAMER 15MM
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270680646
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
REAMER BLADE
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702528
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$19.88 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$266.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.88
|
|
|
REAMER BLADE
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702528
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
REAMER CALIBRATED 2.7mm
|
Facility
|
IP
|
$1,000.00
|
|
| Hospital Charge Code |
270663814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
|
|
REAMER CALIBRATED 2.7mm
|
Facility
|
OP
|
$1,000.00
|
|
| Hospital Charge Code |
270663814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna Commercial |
$380.00
|
| Rate for Payer: Aetna Medicare Advantage |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$255.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$255.00
|
| Rate for Payer: Cigna Commercial |
$500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$260.00
|
| Rate for Payer: Oxford Commercial |
$200.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$200.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.40
|
|
|
REAMER CANN CORING 10MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270666956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.11 |
| Max. Negotiated Rate |
$512.50 |
| Rate for Payer: Aetna Commercial |
$389.50
|
| Rate for Payer: Aetna Medicare Advantage |
$307.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$261.38
|
| Rate for Payer: Cigna Commercial |
$512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.50
|
| Rate for Payer: Oxford Commercial |
$205.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$205.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.11
|
|
|
REAMER CANN CORING 10MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270666956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER CANN CORING 9MM
|
Facility
|
OP
|
$1,025.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270675522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.11 |
| Max. Negotiated Rate |
$512.50 |
| Rate for Payer: Aetna Commercial |
$389.50
|
| Rate for Payer: Aetna Medicare Advantage |
$307.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$261.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$261.38
|
| Rate for Payer: Cigna Commercial |
$512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.50
|
| Rate for Payer: Oxford Commercial |
$205.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$205.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.11
|
|
|
REAMER CANN CORING 9MM
|
Facility
|
IP
|
$1,025.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270675522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER CANN DISTAL 20MM
|
Facility
|
IP
|
$1,473.95
|
|
| Hospital Charge Code |
270679797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$221.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.09
|
|
|
REAMER CANN DISTAL 20MM
|
Facility
|
OP
|
$1,473.95
|
|
| Hospital Charge Code |
270679797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.86 |
| Max. Negotiated Rate |
$736.98 |
| Rate for Payer: Aetna Commercial |
$560.10
|
| Rate for Payer: Aetna Medicare Advantage |
$442.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.86
|
| Rate for Payer: Cigna Commercial |
$736.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$383.23
|
| Rate for Payer: Oxford Commercial |
$294.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$294.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.86
|
|
|
REAMER CANN DISTAL 20MM
|
Facility
|
IP
|
$1,473.95
|
|
| Hospital Charge Code |
270679819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$221.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.09
|
|
|
REAMER CANN DISTAL 20MM
|
Facility
|
OP
|
$1,473.95
|
|
| Hospital Charge Code |
270679819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.86 |
| Max. Negotiated Rate |
$736.98 |
| Rate for Payer: Aetna Commercial |
$560.10
|
| Rate for Payer: Aetna Medicare Advantage |
$442.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.86
|
| Rate for Payer: Cigna Commercial |
$736.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$383.23
|
| Rate for Payer: Oxford Commercial |
$294.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$294.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.86
|
|
|
REAMER CANN DISTAL 20MM
|
Facility
|
IP
|
$1,431.00
|
|
| Hospital Charge Code |
270677394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.65 |
| Max. Negotiated Rate |
$214.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$214.65
|
|
|
REAMER CANN DISTAL 20MM
|
Facility
|
OP
|
$1,431.00
|
|
| Hospital Charge Code |
270677394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.64 |
| Max. Negotiated Rate |
$715.50 |
| Rate for Payer: Aetna Commercial |
$543.78
|
| Rate for Payer: Aetna Medicare Advantage |
$429.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$364.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$364.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$364.90
|
| Rate for Payer: Cigna Commercial |
$715.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$372.06
|
| Rate for Payer: Oxford Commercial |
$286.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$214.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$286.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.64
|
|
|
REAMER CANN PROXIMAL 18MM
|
Facility
|
IP
|
$1,473.95
|
|
| Hospital Charge Code |
270679796
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$221.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.09
|
|
|
REAMER CANN PROXIMAL 18MM
|
Facility
|
OP
|
$1,473.95
|
|
| Hospital Charge Code |
270679796
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.86 |
| Max. Negotiated Rate |
$736.98 |
| Rate for Payer: Aetna Commercial |
$560.10
|
| Rate for Payer: Aetna Medicare Advantage |
$442.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.86
|
| Rate for Payer: Cigna Commercial |
$736.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$383.23
|
| Rate for Payer: Oxford Commercial |
$294.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$294.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.86
|
|
|
REAMER CANN PROXIMAL 20MM
|
Facility
|
OP
|
$1,431.00
|
|
| Hospital Charge Code |
270677393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.64 |
| Max. Negotiated Rate |
$715.50 |
| Rate for Payer: Aetna Commercial |
$543.78
|
| Rate for Payer: Aetna Medicare Advantage |
$429.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$364.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$364.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$364.90
|
| Rate for Payer: Cigna Commercial |
$715.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$372.06
|
| Rate for Payer: Oxford Commercial |
$286.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$214.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$286.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.64
|
|