|
REAMER MODULAR 9.0MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MODULAR 9.0MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.99 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$448.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48.99
|
|
|
REAMER MODULAR 9.5MM HD Q4IM
|
Facility
|
OP
|
$1,725.00
|
|
| Hospital Charge Code |
270694086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.99 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Aetna Commercial |
$655.50
|
| Rate for Payer: Aetna Medicare Advantage |
$517.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$439.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$439.88
|
| Rate for Payer: Cigna Commercial |
$862.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$448.50
|
| Rate for Payer: Oxford Commercial |
$345.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$345.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48.99
|
|
|
REAMER MODULAR 9.5MM HD Q4IM
|
Facility
|
IP
|
$1,725.00
|
|
| Hospital Charge Code |
270694086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.75 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.75
|
|
|
REAMER MTP CUP 18MM GEN 2.455.
|
Facility
|
IP
|
$1,110.00
|
|
| Hospital Charge Code |
270702879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$268.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER MTP CUP 18MM GEN 2.455.
|
Facility
|
OP
|
$1,110.00
|
|
| Hospital Charge Code |
270702879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$421.80
|
| Rate for Payer: Aetna Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$283.05
|
| Rate for Payer: Cigna Commercial |
$555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.52
|
|
|
REAMER MTP CUP 20MM GEN 2.455.
|
Facility
|
IP
|
$1,110.00
|
|
| Hospital Charge Code |
270702880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$268.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
|
|
REAMER MTP CUP 20MM GEN 2.455.
|
Facility
|
OP
|
$1,110.00
|
|
| Hospital Charge Code |
270702880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$421.80
|
| Rate for Payer: Aetna Medicare Advantage |
$333.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$283.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$283.05
|
| Rate for Payer: Cigna Commercial |
$555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$268.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.52
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
OP
|
$5,750.00
|
|
| Hospital Charge Code |
270669666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.30 |
| Max. Negotiated Rate |
$2,875.00 |
| Rate for Payer: Aetna Commercial |
$2,185.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,725.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,466.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,466.25
|
| Rate for Payer: Cigna Commercial |
$2,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,495.00
|
| Rate for Payer: Oxford Commercial |
$1,150.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,150.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$181.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$163.30
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
IP
|
$5,750.00
|
|
| Hospital Charge Code |
270669666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$862.50 |
| Max. Negotiated Rate |
$862.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$862.50
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270674088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REAMER PHALANGEAL 16MM
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270674088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$855.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$585.00
|
| Rate for Payer: Oxford Commercial |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$450.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$63.90
|
|
|
REAMER PILOTED HEADED 7.5MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270674132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER PILOTED HEADED 7.5MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270674132
|
|
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 PILOTED HEADED 8.5MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270674131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.61 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$380.90
|
| Rate for Payer: Oxford Commercial |
$293.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$293.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.61
|
|
|
REAMER PILOTED HEADED 8.5MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270674131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
REAMER PILOT HEADED 7MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270675256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER PILOT HEADED 7MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270675256
|
|
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 PILOT HEADED 8MM
|
Facility
|
IP
|
$1,025.00
|
|
| Hospital Charge Code |
270675258
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.75 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.75
|
|
|
REAMER PILOT HEADED 8MM
|
Facility
|
OP
|
$1,025.00
|
|
| Hospital Charge Code |
270675258
|
|
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 PROXIMAL
|
Facility
|
OP
|
$2,009.80
|
|
| Hospital Charge Code |
270689912
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$1,004.90 |
| Rate for Payer: Aetna Commercial |
$763.72
|
| Rate for Payer: Aetna Medicare Advantage |
$602.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$512.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$512.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$512.50
|
| Rate for Payer: Cigna Commercial |
$1,004.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$522.55
|
| Rate for Payer: Oxford Commercial |
$401.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$401.96
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.08
|
|
|
REAMER PROXIMAL
|
Facility
|
IP
|
$2,009.80
|
|
| Hospital Charge Code |
270689912
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.47 |
| Max. Negotiated Rate |
$301.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.47
|
|
|
REAMER RVS SHOULDER
|
Facility
|
IP
|
$1,501.50
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270696620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.22 |
| Max. Negotiated Rate |
$225.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.22
|
|
|
REAMER RVS SHOULDER
|
Facility
|
OP
|
$1,501.50
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270696620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$750.75 |
| Rate for Payer: Aetna Commercial |
$570.57
|
| Rate for Payer: Aetna Medicare Advantage |
$450.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.88
|
| Rate for Payer: Cigna Commercial |
$750.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$390.39
|
| Rate for Payer: Oxford Commercial |
$300.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$300.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.64
|
|
|
REAMER SHAFT 8x450 0227-3000S
|
Facility
|
OP
|
$650.00
|
|
| Hospital Charge Code |
270638647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$247.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.00
|
| Rate for Payer: Oxford Commercial |
$130.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.46
|
|