|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
OP
|
$8.21
|
|
| Hospital Charge Code |
270604672N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare Advantage |
$2.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.09
|
| Rate for Payer: Cigna Commercial |
$4.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.13
|
| Rate for Payer: Oxford Commercial |
$1.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
IP
|
$8.21
|
|
| Hospital Charge Code |
270604672S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
IP
|
$8.31
|
|
| Hospital Charge Code |
270604671S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.25
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
IP
|
$8.21
|
|
| Hospital Charge Code |
270604672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
OP
|
$8.21
|
|
| Hospital Charge Code |
270604672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare Advantage |
$2.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.09
|
| Rate for Payer: Cigna Commercial |
$4.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.13
|
| Rate for Payer: Oxford Commercial |
$1.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
OP
|
$8.21
|
|
| Hospital Charge Code |
270604673
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare Advantage |
$2.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.09
|
| Rate for Payer: Cigna Commercial |
$4.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.13
|
| Rate for Payer: Oxford Commercial |
$1.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
IP
|
$8.21
|
|
| Hospital Charge Code |
270604672N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
IP
|
$8.21
|
|
| Hospital Charge Code |
270651177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
OP
|
$8.31
|
|
| Hospital Charge Code |
270604671
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.16 |
| Rate for Payer: Aetna Commercial |
$3.16
|
| Rate for Payer: Aetna Medicare Advantage |
$2.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.12
|
| Rate for Payer: Cigna Commercial |
$4.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.16
|
| Rate for Payer: Oxford Commercial |
$1.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.66
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
SUTURE SURGIPRO 2/0 30 BLUE
|
Facility
|
IP
|
$8.31
|
|
| Hospital Charge Code |
270604671N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.25
|
|
|
SUTURE SURGIPRO 2/0 30 BLU KS
|
Facility
|
OP
|
$7.60
|
|
| Hospital Charge Code |
270675600
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$3.80 |
| Rate for Payer: Aetna Commercial |
$2.89
|
| Rate for Payer: Aetna Medicare Advantage |
$2.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.94
|
| Rate for Payer: Cigna Commercial |
$3.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.98
|
| Rate for Payer: Oxford Commercial |
$1.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.52
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.22
|
|
|
SUTURE SURGIPRO 2/0 30 BLU KS
|
Facility
|
IP
|
$7.60
|
|
| Hospital Charge Code |
270675600
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$1.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.14
|
|
|
SUTURESURGIPRO 2-0 36BLUE V-26
|
Facility
|
IP
|
$639.65
|
|
| Hospital Charge Code |
270663701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$95.95 |
| Max. Negotiated Rate |
$95.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.95
|
|
|
SUTURESURGIPRO 2-0 36BLUE V-26
|
Facility
|
OP
|
$639.65
|
|
| Hospital Charge Code |
270663701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$319.82 |
| Rate for Payer: Aetna Commercial |
$243.07
|
| Rate for Payer: Aetna Medicare Advantage |
$191.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$163.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$163.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$163.11
|
| Rate for Payer: Cigna Commercial |
$319.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$166.31
|
| Rate for Payer: Oxford Commercial |
$127.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$127.93
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.17
|
|
|
SUTURE SURGIPRO 2 5-0 BLUE 18
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
270669176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$5.70
|
| Rate for Payer: Aetna Medicare Advantage |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.83
|
| Rate for Payer: Cigna Commercial |
$7.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.90
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.43
|
|
|
SUTURE SURGIPRO 2 5-0 BLUE 18
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
270669176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
|
|
SUTURE SURGIPRO 3.0 18 BLUE
|
Facility
|
IP
|
$15.55
|
|
| Hospital Charge Code |
270656163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$2.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.33
|
|
|
SUTURE SURGIPRO 3.0 18 BLUE
|
Facility
|
OP
|
$15.55
|
|
| Hospital Charge Code |
270656163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Aetna Commercial |
$5.91
|
| Rate for Payer: Aetna Medicare Advantage |
$4.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.97
|
| Rate for Payer: Cigna Commercial |
$7.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.04
|
| Rate for Payer: Oxford Commercial |
$3.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.44
|
|
|
SUTURE SURGIPRO 3/0 18 BLU FS1
|
Facility
|
IP
|
$8.21
|
|
| Hospital Charge Code |
270675601
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
|
|
SUTURE SURGIPRO 3/0 18 BLU FS1
|
Facility
|
OP
|
$8.21
|
|
| Hospital Charge Code |
270675601
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare Advantage |
$2.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.09
|
| Rate for Payer: Cigna Commercial |
$4.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.13
|
| Rate for Payer: Oxford Commercial |
$1.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
SUTURE SURGIPRO 3/0 18 BLU PC5
|
Facility
|
IP
|
$17.85
|
|
| Hospital Charge Code |
270675602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$2.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.68
|
|
|
SUTURE SURGIPRO 3/0 18 BLU PC5
|
Facility
|
OP
|
$17.85
|
|
| Hospital Charge Code |
270675602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Aetna Commercial |
$6.78
|
| Rate for Payer: Aetna Medicare Advantage |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.55
|
| Rate for Payer: Cigna Commercial |
$8.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.64
|
| Rate for Payer: Oxford Commercial |
$3.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.51
|
|
|
SUTURE SURGIPRO 4/0 18 BLUE
|
Facility
|
IP
|
$8.21
|
|
| Hospital Charge Code |
270600784
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
|
|
SUTURE SURGIPRO 4/0 18 BLUE
|
Facility
|
OP
|
$8.21
|
|
| Hospital Charge Code |
270600784
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare Advantage |
$2.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.09
|
| Rate for Payer: Cigna Commercial |
$4.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.13
|
| Rate for Payer: Oxford Commercial |
$1.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
SUTURE SURGIPRO 4/0 18 BLU FS1
|
Facility
|
OP
|
$8.21
|
|
| Hospital Charge Code |
270651176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare Advantage |
$2.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.09
|
| Rate for Payer: Cigna Commercial |
$4.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.13
|
| Rate for Payer: Oxford Commercial |
$1.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|