|
SAW BLADE 12/25/4MM SHORT 45
|
Facility
|
OP
|
$1,172.50
|
|
| Hospital Charge Code |
270674845
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$586.25 |
| Rate for Payer: Aetna Commercial |
$445.55
|
| Rate for Payer: Aetna Medicare Advantage |
$351.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$298.99
|
| Rate for Payer: Cigna Commercial |
$586.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.85
|
| Rate for Payer: Oxford Commercial |
$234.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$234.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.30
|
|
|
SAW BLADE 12/25/4MM SHORT 90
|
Facility
|
IP
|
$1,172.50
|
|
| Hospital Charge Code |
270674840
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.88 |
| Max. Negotiated Rate |
$175.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
|
|
SAW BLADE 12/25/4MM SHORT 90
|
Facility
|
OP
|
$1,172.50
|
|
| Hospital Charge Code |
270674840
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$586.25 |
| Rate for Payer: Aetna Commercial |
$445.55
|
| Rate for Payer: Aetna Medicare Advantage |
$351.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$298.99
|
| Rate for Payer: Cigna Commercial |
$586.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.85
|
| Rate for Payer: Oxford Commercial |
$234.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$234.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.30
|
|
|
SAW BLADE 12/25/5MM SHORT 45
|
Facility
|
IP
|
$1,172.50
|
|
| Hospital Charge Code |
270674846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.88 |
| Max. Negotiated Rate |
$175.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
|
|
SAW BLADE 12/25/5MM SHORT 45
|
Facility
|
OP
|
$1,172.50
|
|
| Hospital Charge Code |
270674846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$586.25 |
| Rate for Payer: Aetna Commercial |
$445.55
|
| Rate for Payer: Aetna Medicare Advantage |
$351.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$298.99
|
| Rate for Payer: Cigna Commercial |
$586.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.85
|
| Rate for Payer: Oxford Commercial |
$234.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$234.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.30
|
|
|
SAW BLADE 12/25/5MM SHORT 90
|
Facility
|
IP
|
$1,172.50
|
|
| Hospital Charge Code |
270674841
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.88 |
| Max. Negotiated Rate |
$175.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
|
|
SAW BLADE 12/25/5MM SHORT 90
|
Facility
|
OP
|
$1,172.50
|
|
| Hospital Charge Code |
270674841
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$586.25 |
| Rate for Payer: Aetna Commercial |
$445.55
|
| Rate for Payer: Aetna Medicare Advantage |
$351.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$298.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$298.99
|
| Rate for Payer: Cigna Commercial |
$586.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.85
|
| Rate for Payer: Oxford Commercial |
$234.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$234.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.30
|
|
|
SAW BLADE 12.5x90x0.9MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
|
|
SAW BLADE 12.5x90x0.9MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.93 |
| Max. Negotiated Rate |
$192.50 |
| Rate for Payer: Aetna Commercial |
$146.30
|
| Rate for Payer: Aetna Medicare Advantage |
$115.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.17
|
| Rate for Payer: Cigna Commercial |
$192.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.10
|
| Rate for Payer: Oxford Commercial |
$77.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.93
|
|
|
SAW BLADE 12x20x0.4MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$126.35
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.45
|
| Rate for Payer: Oxford Commercial |
$66.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.44
|
|
|
SAW BLADE 12x20x0.4MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 13x3x0.4MM THIN
|
Facility
|
IP
|
$413.00
|
|
| Hospital Charge Code |
270674672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.95 |
| Max. Negotiated Rate |
$61.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.95
|
|
|
SAW BLADE 13x3x0.4MM THIN
|
Facility
|
OP
|
$413.00
|
|
| Hospital Charge Code |
270674672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.73 |
| Max. Negotiated Rate |
$206.50 |
| Rate for Payer: Aetna Commercial |
$156.94
|
| Rate for Payer: Aetna Medicare Advantage |
$123.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.31
|
| Rate for Payer: Cigna Commercial |
$206.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$107.38
|
| Rate for Payer: Oxford Commercial |
$82.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$82.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.73
|
|
|
SAW BLADE 13x6.4/2.9x0.6MM REC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
SAW BLADE 13x6.4/2.9x0.6MM REC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
SAW BLADE 14.5x4x0.6MM REC SAW
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
SAW BLADE 14.5x4x0.6MM REC SAW
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
SAW BLADE 14x25x0.6MM CUT
|
Facility
|
OP
|
$318.50
|
|
| Hospital Charge Code |
270674827
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$121.03
|
| Rate for Payer: Aetna Medicare Advantage |
$95.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.22
|
| Rate for Payer: Cigna Commercial |
$159.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.81
|
| Rate for Payer: Oxford Commercial |
$63.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.05
|
|
|
SAW BLADE 14x25x0.6MM CUT
|
Facility
|
IP
|
$318.50
|
|
| Hospital Charge Code |
270674827
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$47.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.77
|
|
|
SAW BLADE 14x25x0.6MM CUT
|
Facility
|
IP
|
$290.50
|
|
| Hospital Charge Code |
270674808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$43.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
|
|
SAW BLADE 14x25x0.6MM CUT
|
Facility
|
OP
|
$290.50
|
|
| Hospital Charge Code |
270674808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$145.25 |
| Rate for Payer: Aetna Commercial |
$110.39
|
| Rate for Payer: Aetna Medicare Advantage |
$87.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$74.08
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.53
|
| Rate for Payer: Oxford Commercial |
$58.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.25
|
|
|
SAW BLADE 14x25x0.6MM CUT STR
|
Facility
|
IP
|
$332.50
|
|
| Hospital Charge Code |
270674828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
|
|
SAW BLADE 14x25x0.6MM CUT STR
|
Facility
|
OP
|
$332.50
|
|
| Hospital Charge Code |
270674828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$166.25 |
| Rate for Payer: Aetna Commercial |
$126.35
|
| Rate for Payer: Aetna Medicare Advantage |
$99.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.79
|
| Rate for Payer: Cigna Commercial |
$166.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.45
|
| Rate for Payer: Oxford Commercial |
$66.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.44
|
|
|
SAW BLADE 14x50x0.6MM CUT
|
Facility
|
IP
|
$290.50
|
|
| Hospital Charge Code |
270674802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$43.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
|
|
SAW BLADE 14x50x0.6MM CUT
|
Facility
|
OP
|
$290.50
|
|
| Hospital Charge Code |
270674802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$145.25 |
| Rate for Payer: Aetna Commercial |
$110.39
|
| Rate for Payer: Aetna Medicare Advantage |
$87.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$74.08
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.53
|
| Rate for Payer: Oxford Commercial |
$58.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.25
|
|