|
SUTURE SURGIPRO II 3/0 18 BLU
|
Facility
|
OP
|
$16.32
|
|
| Hospital Charge Code |
270610869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$8.16 |
| Rate for Payer: Aetna Commercial |
$6.20
|
| Rate for Payer: Aetna Medicare Advantage |
$4.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.16
|
| Rate for Payer: Cigna Commercial |
$8.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.24
|
| Rate for Payer: Oxford Commercial |
$3.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.26
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.46
|
|
|
SUTURE SURGIPRO II 3/0 18 BLU
|
Facility
|
IP
|
$16.32
|
|
| Hospital Charge Code |
270610869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.45
|
|
|
SUTURE SURGIPRO II 3/0 18 BLU
|
Facility
|
OP
|
$16.78
|
|
| Hospital Charge Code |
270669227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$8.39 |
| Rate for Payer: Aetna Commercial |
$6.38
|
| Rate for Payer: Aetna Medicare Advantage |
$5.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.28
|
| Rate for Payer: Cigna Commercial |
$8.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.36
|
| Rate for Payer: Oxford Commercial |
$3.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.36
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.48
|
|
|
SUTURE SURGIPRO II 3/0 18 BLU
|
Facility
|
IP
|
$16.78
|
|
| Hospital Charge Code |
270669227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$2.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.52
|
|
|
SUTURE SURGIPRO II 3/0 30 BLU
|
Facility
|
OP
|
$8.62
|
|
| Hospital Charge Code |
270604676N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.31 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.24
|
| Rate for Payer: Oxford Commercial |
$1.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
SUTURE SURGIPRO II 3/0 30 BLU
|
Facility
|
IP
|
$8.62
|
|
| Hospital Charge Code |
270604676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
SUTURE SURGIPRO II 3/0 30 BLU
|
Facility
|
IP
|
$8.62
|
|
| Hospital Charge Code |
270604676S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
SUTURE SURGIPRO II 3/0 30 BLU
|
Facility
|
IP
|
$8.62
|
|
| Hospital Charge Code |
270604676N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
SUTURE SURGIPRO II 3/0 30 BLU
|
Facility
|
OP
|
$8.62
|
|
| Hospital Charge Code |
270604676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.31 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.24
|
| Rate for Payer: Oxford Commercial |
$1.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
SUTURE SURGIPRO II 3/0 30 BLU
|
Facility
|
OP
|
$8.62
|
|
| Hospital Charge Code |
270604676S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.31 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.24
|
| Rate for Payer: Oxford Commercial |
$1.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
SUTURE SURGIPRO II 3/0 36 BLU
|
Facility
|
IP
|
$17.24
|
|
| Hospital Charge Code |
270614138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$2.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.59
|
|
|
SUTURE SURGIPRO II 3/0 36 BLU
|
Facility
|
OP
|
$23.82
|
|
| Hospital Charge Code |
270604675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$11.91 |
| Rate for Payer: Aetna Commercial |
$9.05
|
| Rate for Payer: Aetna Medicare Advantage |
$7.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.07
|
| Rate for Payer: Cigna Commercial |
$11.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.19
|
| Rate for Payer: Oxford Commercial |
$4.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.76
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.68
|
|
|
SUTURE SURGIPRO II 3/0 36 BLU
|
Facility
|
OP
|
$17.24
|
|
| Hospital Charge Code |
270614138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$8.62 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Medicare Advantage |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.40
|
| Rate for Payer: Cigna Commercial |
$8.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.48
|
| Rate for Payer: Oxford Commercial |
$3.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.49
|
|
|
SUTURE SURGIPRO II 3/0 36 BLU
|
Facility
|
IP
|
$23.82
|
|
| Hospital Charge Code |
270604675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$3.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.57
|
|
|
SUTURE SURGIPRO II 4/0 18 BLU
|
Facility
|
IP
|
$15.55
|
|
| Hospital Charge Code |
270651320
|
|
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 II 4/0 18 BLU
|
Facility
|
IP
|
$16.73
|
|
| Hospital Charge Code |
270649097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$2.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.51
|
|
|
SUTURE SURGIPRO II 4/0 18 BLU
|
Facility
|
OP
|
$15.55
|
|
| Hospital Charge Code |
270651320
|
|
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 II 4/0 18 BLU
|
Facility
|
OP
|
$16.73
|
|
| Hospital Charge Code |
270649097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Aetna Commercial |
$6.36
|
| Rate for Payer: Aetna Medicare Advantage |
$5.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.27
|
| Rate for Payer: Cigna Commercial |
$8.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.35
|
| Rate for Payer: Oxford Commercial |
$3.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.48
|
|
|
SUTURE SURGIPRO II 4/0 30 BLU
|
Facility
|
IP
|
$8.62
|
|
| Hospital Charge Code |
270617471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
SUTURE SURGIPRO II 4/0 30 BLU
|
Facility
|
OP
|
$8.62
|
|
| Hospital Charge Code |
270617471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.31 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.24
|
| Rate for Payer: Oxford Commercial |
$1.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
SUTURE SURGIPRO II 4/0 36 BLU
|
Facility
|
OP
|
$24.07
|
|
| Hospital Charge Code |
270604677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$12.04 |
| Rate for Payer: Aetna Commercial |
$9.15
|
| Rate for Payer: Aetna Medicare Advantage |
$7.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.14
|
| Rate for Payer: Cigna Commercial |
$12.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.26
|
| Rate for Payer: Oxford Commercial |
$4.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.68
|
|
|
SUTURE SURGIPRO II 4/0 36 BLU
|
Facility
|
IP
|
$24.07
|
|
| Hospital Charge Code |
270604677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$3.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.61
|
|
|
SUTURE SURGIPRO II 4/0 36 IN
|
Facility
|
OP
|
$22.05
|
|
| Hospital Charge Code |
270660279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$11.03 |
| Rate for Payer: Aetna Commercial |
$8.38
|
| Rate for Payer: Aetna Medicare Advantage |
$6.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.62
|
| Rate for Payer: Cigna Commercial |
$11.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.73
|
| Rate for Payer: Oxford Commercial |
$4.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.63
|
|
|
SUTURE SURGIPRO II 4/0 36 IN
|
Facility
|
IP
|
$22.05
|
|
| Hospital Charge Code |
270660279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$3.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.31
|
|
|
SUTURE SURGIPRO II 4/0 36 RB1
|
Facility
|
IP
|
$17.24
|
|
| Hospital Charge Code |
270663888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$2.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.59
|
|