|
SAW BLADE 9.2x7.3x0.6MM LT IBO
|
Facility
|
OP
|
$413.00
|
|
| Hospital Charge Code |
270674674
|
|
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 9.2x7.3x0.6MM RT IBO
|
Facility
|
OP
|
$413.00
|
|
| Hospital Charge Code |
270674675
|
|
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 9.2x7.3x0.6MM RT IBO
|
Facility
|
IP
|
$413.00
|
|
| Hospital Charge Code |
270674675
|
|
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 95MMx19MM 0.89MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674708
|
|
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 95MMx19MM 0.89MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674708
|
|
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 95MMx19MM 1.00MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674714
|
|
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 95MMx19MM 1.00MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674714
|
|
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 95MMx19MM 1.07MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674715
|
|
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 95MMx19MM 1.07MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674715
|
|
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 95MMx19MM 1.19MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674709
|
|
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 95MMx19MM 1.19MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674709
|
|
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 95MMx19MM 1.27MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674710
|
|
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 95MMx19MM 1.27MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674710
|
|
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 95MMx19MM 1.37MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674711
|
|
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 95MMx19MM 1.37MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674711
|
|
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 95MMx19MM 1.47MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674712
|
|
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 95MMx19MM 1.47MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674712
|
|
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 95MMx25MM 0.89MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674716
|
|
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 95MMx25MM 0.89MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674716
|
|
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 95MMx25MM 1.00MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674721
|
|
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 95MMx25MM 1.00MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674721
|
|
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 95MMx25MM 1.07MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674722
|
|
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 95MMx25MM 1.07MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674722
|
|
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 95MMx25MM 1.19MM CUT
|
Facility
|
IP
|
$385.00
|
|
| Hospital Charge Code |
270674717
|
|
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 95MMx25MM 1.19MM CUT
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
270674717
|
|
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
|
|