|
BIT DRILL
|
Facility
|
OP
|
$260.00
|
|
| Hospital Charge Code |
270656827
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$98.80
|
| Rate for Payer: Aetna Medicare Advantage |
$78.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.30
|
| Rate for Payer: Cigna Commercial |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.60
|
| Rate for Payer: Oxford Commercial |
$52.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.38
|
|
|
BIT DRILL 10.0mm 190mm QC
|
Facility
|
OP
|
$2,694.50
|
|
| Hospital Charge Code |
270650161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.52 |
| Max. Negotiated Rate |
$1,347.25 |
| Rate for Payer: Aetna Commercial |
$1,023.91
|
| Rate for Payer: Aetna Medicare Advantage |
$808.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$687.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$687.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$687.10
|
| Rate for Payer: Cigna Commercial |
$1,347.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$700.57
|
| Rate for Payer: Oxford Commercial |
$538.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$404.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$538.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$85.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.52
|
|
|
BIT DRILL 10.0mm 190mm QC
|
Facility
|
IP
|
$2,694.50
|
|
| Hospital Charge Code |
270650161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.18 |
| Max. Negotiated Rate |
$404.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$404.18
|
|
|
BIT DRILL 10.0MM 190MM QC LRG
|
Facility
|
IP
|
$2,562.05
|
|
| Hospital Charge Code |
270680673
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$384.31 |
| Max. Negotiated Rate |
$384.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$384.31
|
|
|
BIT DRILL 10.0MM 190MM QC LRG
|
Facility
|
OP
|
$2,562.05
|
|
| Hospital Charge Code |
270680673
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.76 |
| Max. Negotiated Rate |
$1,281.03 |
| Rate for Payer: Aetna Commercial |
$973.58
|
| Rate for Payer: Aetna Medicare Advantage |
$768.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$653.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$653.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$653.32
|
| Rate for Payer: Cigna Commercial |
$1,281.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$666.13
|
| Rate for Payer: Oxford Commercial |
$512.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$384.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$512.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$80.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$72.76
|
|
|
BIT DRILL 11MM TRI FLAT ZEPHIR
|
Facility
|
OP
|
$1,400.00
|
|
| Hospital Charge Code |
270654836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.76 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Commercial |
$532.00
|
| Rate for Payer: Aetna Medicare Advantage |
$420.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$280.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$357.00
|
| Rate for Payer: Cigna Commercial |
$700.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$338.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$210.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.76
|
|
|
BIT DRILL 11MM TRI FLAT ZEPHIR
|
Facility
|
IP
|
$1,400.00
|
|
| Hospital Charge Code |
270654836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$338.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$280.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$338.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$210.00
|
|
|
BIT DRILL 1.8mm W/DEPTH GAUGE
|
Facility
|
OP
|
$652.45
|
|
| Hospital Charge Code |
207661256
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$326.23 |
| Rate for Payer: Aetna Commercial |
$247.93
|
| Rate for Payer: Aetna Medicare Advantage |
$195.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$166.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$166.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$166.37
|
| Rate for Payer: Cigna Commercial |
$326.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.64
|
| Rate for Payer: Oxford Commercial |
$130.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.49
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.53
|
|
|
BIT DRILL 1.8mm W/DEPTH GAUGE
|
Facility
|
IP
|
$652.45
|
|
| Hospital Charge Code |
207661256
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.87 |
| Max. Negotiated Rate |
$97.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.87
|
|
|
BIT DRILL 2.0mm
|
Facility
|
OP
|
$795.60
|
|
| Hospital Charge Code |
270648599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Commercial |
$302.33
|
| Rate for Payer: Aetna Medicare Advantage |
$238.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$202.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$202.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$202.88
|
| Rate for Payer: Cigna Commercial |
$397.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$206.86
|
| Rate for Payer: Oxford Commercial |
$159.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.60
|
|
|
BIT DRILL 2.0mm
|
Facility
|
IP
|
$795.60
|
|
| Hospital Charge Code |
270648599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.34 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.34
|
|
|
BIT DRILL 2.0MM
|
Facility
|
IP
|
$875.00
|
|
| Hospital Charge Code |
270648826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.25
|
|
|
BIT DRILL 2.0MM
|
Facility
|
OP
|
$875.00
|
|
| Hospital Charge Code |
270648826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.85 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna Commercial |
$332.50
|
| Rate for Payer: Aetna Medicare Advantage |
$262.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.12
|
| Rate for Payer: Cigna Commercial |
$437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$227.50
|
| Rate for Payer: Oxford Commercial |
$175.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.85
|
|
|
BIT DRILL 2.0MM CALIBRATED
|
Facility
|
OP
|
$625.00
|
|
| Hospital Charge Code |
270646199
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$312.50 |
| Rate for Payer: Aetna Commercial |
$237.50
|
| Rate for Payer: Aetna Medicare Advantage |
$187.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$159.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$159.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$159.38
|
| Rate for Payer: Cigna Commercial |
$312.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.50
|
| Rate for Payer: Oxford Commercial |
$125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$125.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.75
|
|
|
BIT DRILL 2.0MM CALIBRATED
|
Facility
|
IP
|
$625.00
|
|
| Hospital Charge Code |
270646199
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.75 |
| Max. Negotiated Rate |
$93.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.75
|
|
|
BIT DRILL 2.0MMX33.5MM
|
Facility
|
OP
|
$1,535.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270693532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.59 |
| Max. Negotiated Rate |
$767.50 |
| Rate for Payer: Aetna Commercial |
$583.30
|
| Rate for Payer: Aetna Medicare Advantage |
$460.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$391.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$391.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$391.43
|
| Rate for Payer: Cigna Commercial |
$767.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$399.10
|
| Rate for Payer: Oxford Commercial |
$307.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$230.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$307.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.59
|
|
|
BIT DRILL 2.0MMX33.5MM
|
Facility
|
IP
|
$1,535.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270693532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$230.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$230.25
|
|
|
BIT DRILL 2.3x125mm
|
Facility
|
IP
|
$601.20
|
|
| Hospital Charge Code |
270671846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.18 |
| Max. Negotiated Rate |
$90.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.18
|
|
|
BIT DRILL 2.3x125mm
|
Facility
|
OP
|
$601.20
|
|
| Hospital Charge Code |
270671846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.07 |
| Max. Negotiated Rate |
$300.60 |
| Rate for Payer: Aetna Commercial |
$228.46
|
| Rate for Payer: Aetna Medicare Advantage |
$180.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$153.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$153.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$153.31
|
| Rate for Payer: Cigna Commercial |
$300.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$156.31
|
| Rate for Payer: Oxford Commercial |
$120.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$120.24
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.07
|
|
|
BIT DRILL 2.4MM
|
Facility
|
IP
|
$395.00
|
|
| Hospital Charge Code |
270677000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
BIT DRILL 2.4MM
|
Facility
|
OP
|
$395.00
|
|
| Hospital Charge Code |
270677000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$197.50 |
| Rate for Payer: Aetna Commercial |
$150.10
|
| Rate for Payer: Aetna Medicare Advantage |
$118.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.72
|
| Rate for Payer: Cigna Commercial |
$197.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.70
|
| Rate for Payer: Oxford Commercial |
$79.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$79.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.22
|
|
|
BIT DRILL 2.5 700347
|
Facility
|
OP
|
$681.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648056
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.34 |
| Max. Negotiated Rate |
$340.55 |
| Rate for Payer: Aetna Commercial |
$258.82
|
| Rate for Payer: Aetna Medicare Advantage |
$204.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$173.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$173.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$173.68
|
| Rate for Payer: Cigna Commercial |
$340.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$164.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.34
|
|
|
BIT DRILL 2.5 700347
|
Facility
|
IP
|
$681.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648056
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.17 |
| Max. Negotiated Rate |
$164.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$164.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.17
|
|
|
BIT DRILL 2.5x95mm GOLD
|
Facility
|
IP
|
$307.45
|
|
| Hospital Charge Code |
270604450
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.12 |
| Max. Negotiated Rate |
$46.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.12
|
|
|
BIT DRILL 2.5x95mm GOLD
|
Facility
|
OP
|
$307.45
|
|
| Hospital Charge Code |
270604450
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial |
$116.83
|
| Rate for Payer: Aetna Medicare Advantage |
$92.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78.40
|
| Rate for Payer: Cigna Commercial |
$153.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.94
|
| Rate for Payer: Oxford Commercial |
$61.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.49
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.73
|
|