|
BIT DRILL 2.6MM 703702
|
Facility
|
IP
|
$750.00
|
|
| Hospital Charge Code |
270648598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
BIT DRILL 2.6MM 703702
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
270648598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Oxford Commercial |
$150.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$150.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
BIT DRILL 2.7MM
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
270647952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
BIT DRILL 2.7MM
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
270647952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$199.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$136.50
|
| Rate for Payer: Oxford Commercial |
$105.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$105.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.91
|
|
|
BIT DRILL 2.8MM
|
Facility
|
OP
|
$660.00
|
|
| Hospital Charge Code |
270677147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$250.80
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$171.60
|
| Rate for Payer: Oxford Commercial |
$132.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.74
|
|
|
BIT DRILL 2.8MM
|
Facility
|
IP
|
$660.00
|
|
| Hospital Charge Code |
270677147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
BIT DRILL 2.8MM CALIBRATED
|
Facility
|
OP
|
$545.00
|
|
| Hospital Charge Code |
270646197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.48 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$207.10
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$141.70
|
| Rate for Payer: Oxford Commercial |
$109.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.48
|
|
|
BIT DRILL 2.8MM CALIBRATED
|
Facility
|
IP
|
$545.00
|
|
| Hospital Charge Code |
270646197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$81.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
BIT DRILL 3.0MM
|
Facility
|
IP
|
$395.00
|
|
| Hospital Charge Code |
270677001
|
|
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 3.0MM
|
Facility
|
OP
|
$395.00
|
|
| Hospital Charge Code |
270677001
|
|
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 3.0MM
|
Facility
|
OP
|
$575.00
|
|
| Hospital Charge Code |
270664800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.33 |
| Max. Negotiated Rate |
$287.50 |
| Rate for Payer: Aetna Commercial |
$218.50
|
| Rate for Payer: Aetna Medicare Advantage |
$172.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$146.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$146.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$146.62
|
| Rate for Payer: Cigna Commercial |
$287.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.50
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.33
|
|
|
BIT DRILL 3.0MM
|
Facility
|
IP
|
$575.00
|
|
| Hospital Charge Code |
270664800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
|
|
BIT DRILL 3.1mm X 204mm
|
Facility
|
OP
|
$597.40
|
|
| Hospital Charge Code |
270640120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.97 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna Commercial |
$227.01
|
| Rate for Payer: Aetna Medicare Advantage |
$179.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$152.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$152.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$152.34
|
| Rate for Payer: Cigna Commercial |
$298.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$155.32
|
| Rate for Payer: Oxford Commercial |
$119.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.97
|
|
|
BIT DRILL 3.1mm X 204mm
|
Facility
|
IP
|
$597.40
|
|
| Hospital Charge Code |
270640120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.61 |
| Max. Negotiated Rate |
$89.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.61
|
|
|
BIT DRILL 3.2mm
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270671871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Oxford Commercial |
$85.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
BIT DRILL 3.2mm
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270671871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
BIT DRILL 3.5 700349
|
Facility
|
OP
|
$950.00
|
|
| Hospital Charge Code |
270648061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Aetna Commercial |
$361.00
|
| Rate for Payer: Aetna Medicare Advantage |
$285.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$242.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$242.25
|
| Rate for Payer: Cigna Commercial |
$475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.00
|
| Rate for Payer: Oxford Commercial |
$190.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.98
|
|
|
BIT DRILL 3.5 700349
|
Facility
|
IP
|
$950.00
|
|
| Hospital Charge Code |
270648061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
|
|
BIT DRILL 3.8mm
|
Facility
|
OP
|
$870.00
|
|
| Hospital Charge Code |
270671864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$330.60
|
| Rate for Payer: Aetna Medicare Advantage |
$261.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.85
|
| Rate for Payer: Cigna Commercial |
$435.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$226.20
|
| Rate for Payer: Oxford Commercial |
$174.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$174.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.71
|
|
|
BIT DRILL 3.8mm
|
Facility
|
IP
|
$870.00
|
|
| Hospital Charge Code |
270671864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.50 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.50
|
|
|
BIT DRILL 3.8mm 270mm QC
|
Facility
|
OP
|
$1,100.05
|
|
| Hospital Charge Code |
270650159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.24 |
| Max. Negotiated Rate |
$550.02 |
| Rate for Payer: Aetna Commercial |
$418.02
|
| Rate for Payer: Aetna Medicare Advantage |
$330.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$280.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$280.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$280.51
|
| Rate for Payer: Cigna Commercial |
$550.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$286.01
|
| Rate for Payer: Oxford Commercial |
$220.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$220.01
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.24
|
|
|
BIT DRILL 3.8mm 270mm QC
|
Facility
|
IP
|
$1,100.05
|
|
| Hospital Charge Code |
270650159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.01 |
| Max. Negotiated Rate |
$165.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.01
|
|
|
BIT DRILL 3-FLUTED 2.9/3.2x150
|
Facility
|
OP
|
$762.00
|
|
| Hospital Charge Code |
270662831
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$381.00 |
| Rate for Payer: Aetna Commercial |
$289.56
|
| Rate for Payer: Aetna Medicare Advantage |
$228.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$194.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$194.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$194.31
|
| Rate for Payer: Cigna Commercial |
$381.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$198.12
|
| Rate for Payer: Oxford Commercial |
$152.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$152.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.64
|
|
|
BIT DRILL 3-FLUTED 2.9/3.2x150
|
Facility
|
IP
|
$762.00
|
|
| Hospital Charge Code |
270662831
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.30 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.30
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
OP
|
$954.80
|
|
| Hospital Charge Code |
270647424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.12 |
| Max. Negotiated Rate |
$477.40 |
| Rate for Payer: Aetna Commercial |
$362.82
|
| Rate for Payer: Aetna Medicare Advantage |
$286.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$243.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$243.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$243.47
|
| Rate for Payer: Cigna Commercial |
$477.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$248.25
|
| Rate for Payer: Oxford Commercial |
$190.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.96
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.12
|
|