|
SAW BLADE 90x12.5-19MM 1.19MM
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674729
|
|
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 90x12.5-19MM 1.19MM
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674729
|
|
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 90x12.5-19MM 1.27MM
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674730
|
|
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 90x12.5-19MM 1.27MM
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674730
|
|
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 90x12.5-19MM 1.37MM
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674731
|
|
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 90x12.5-19MM 1.37MM
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674731
|
|
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 90x12.5-19MM 1.47MM
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674732
|
|
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 90x12.5-19MM 1.47MM
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674732
|
|
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 90x12.5MM 0.89MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x12.5MM 0.89MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674723
|
|
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 90x12.5MM 0.89MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$89.11
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.97
|
| Rate for Payer: Oxford Commercial |
$46.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.66
|
|
|
SAW BLADE 90x12.5MM 0.89MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674723
|
|
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 90x12.5MM 1.00MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674738
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x12.5MM 1.00MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674738
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$89.11
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.97
|
| Rate for Payer: Oxford Commercial |
$46.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.66
|
|
|
SAW BLADE 90x12.5MM 1.07MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$89.11
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.97
|
| Rate for Payer: Oxford Commercial |
$46.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.66
|
|
|
SAW BLADE 90x12.5MM 1.07MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x12.5MM 1.19MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674724
|
|
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 90x12.5MM 1.19MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x12.5MM 1.19MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674724
|
|
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 90x12.5MM 1.19MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$89.11
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.97
|
| Rate for Payer: Oxford Commercial |
$46.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.66
|
|
|
SAW BLADE 90x12.5MM 1.27MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674725
|
|
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 90x12.5MM 1.27MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674725
|
|
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 90x12.5MM 1.27MM CUT
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
270674741
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
|
|
SAW BLADE 90x12.5MM 1.27MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674741
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$89.11
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.97
|
| Rate for Payer: Oxford Commercial |
$46.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.66
|
|
|
SAW BLADE 90x12.5MM 1.37MM CUT
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
270674742
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Aetna Commercial |
$89.11
|
| Rate for Payer: Aetna Medicare Advantage |
$70.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.80
|
| Rate for Payer: Cigna Commercial |
$117.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.97
|
| Rate for Payer: Oxford Commercial |
$46.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.66
|
|