|
REAMER HEADED CANNULATED 10MM
|
Facility
|
OP
|
$1,130.00
|
|
| Hospital Charge Code |
270601370
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.09 |
| Max. Negotiated Rate |
$565.00 |
| Rate for Payer: Aetna Commercial |
$429.40
|
| Rate for Payer: Aetna Medicare Advantage |
$339.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$288.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$288.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$288.15
|
| Rate for Payer: Cigna Commercial |
$565.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$293.80
|
| Rate for Payer: Oxford Commercial |
$226.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$226.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.09
|
|
|
REAMER HEADED CANNULATED 5.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655167
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 5.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655167
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655166
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655166
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 6.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 6.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 6MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 6MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 7.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 7.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 7MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270636833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 7MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270636833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 8.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270655172
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 8.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270655172
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 8MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270636064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 8MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270636064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 9.5MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270673803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 9.5MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270673803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HEADED CANNULATED 9MM
|
Facility
|
OP
|
$1,075.00
|
|
| Hospital Charge Code |
270652019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$537.50 |
| Rate for Payer: Aetna Commercial |
$408.50
|
| Rate for Payer: Aetna Medicare Advantage |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$274.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$274.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.50
|
| Rate for Payer: Oxford Commercial |
$215.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.53
|
|
|
REAMER HEADED CANNULATED 9MM
|
Facility
|
IP
|
$1,075.00
|
|
| Hospital Charge Code |
270652019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
REAMER HOLLOW F/3.5/4.0MM SCRW
|
Facility
|
IP
|
$1,665.00
|
|
| Hospital Charge Code |
270676857
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.75 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.75
|
|
|
REAMER HOLLOW F/3.5/4.0MM SCRW
|
Facility
|
OP
|
$1,665.00
|
|
| Hospital Charge Code |
270676857
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Aetna Commercial |
$632.70
|
| Rate for Payer: Aetna Medicare Advantage |
$499.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.57
|
| Rate for Payer: Cigna Commercial |
$832.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$432.90
|
| Rate for Payer: Oxford Commercial |
$333.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$333.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$52.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.29
|
|
|
REAMER HOLLOW F/6.5/7.0MM SCRW
|
Facility
|
OP
|
$1,714.95
|
|
| Hospital Charge Code |
270654491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.70 |
| Max. Negotiated Rate |
$857.48 |
| Rate for Payer: Aetna Commercial |
$651.68
|
| Rate for Payer: Aetna Medicare Advantage |
$514.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.31
|
| Rate for Payer: Cigna Commercial |
$857.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$445.89
|
| Rate for Payer: Oxford Commercial |
$342.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$257.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$342.99
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48.70
|
|
|
REAMER HOLLOW F/6.5/7.0MM SCRW
|
Facility
|
IP
|
$1,714.95
|
|
| Hospital Charge Code |
270654491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$257.24 |
| Max. Negotiated Rate |
$257.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$257.24
|
|