|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
IP
|
$741.55
|
|
| Hospital Charge Code |
270679778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.23 |
| Max. Negotiated Rate |
$111.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.23
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
IP
|
$698.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.75 |
| Max. Negotiated Rate |
$169.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$139.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.75
|
|
|
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
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
OP
|
$698.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.83 |
| Max. Negotiated Rate |
$349.18 |
| Rate for Payer: Aetna Commercial |
$265.37
|
| Rate for Payer: Aetna Medicare Advantage |
$209.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$139.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.08
|
| Rate for Payer: Cigna Commercial |
$349.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.83
|
|
|
BIT DRILL 3-FLUTED 3.2x145MM
|
Facility
|
IP
|
$954.80
|
|
| Hospital Charge Code |
270647424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.22 |
| Max. Negotiated Rate |
$143.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
|
|
BIT DRILL 3-FLUTED 3.2x145 ST
|
Facility
|
OP
|
$954.80
|
|
| Hospital Charge Code |
270674886
|
|
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
|
|
|
BIT DRILL 3-FLUTED 3.2x145 ST
|
Facility
|
IP
|
$954.80
|
|
| Hospital Charge Code |
270674886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.22 |
| Max. Negotiated Rate |
$143.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.22
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
OP
|
$1,040.75
|
|
| Hospital Charge Code |
270679779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$520.38 |
| Rate for Payer: Aetna Commercial |
$395.49
|
| Rate for Payer: Aetna Medicare Advantage |
$312.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$265.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$265.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$265.39
|
| Rate for Payer: Cigna Commercial |
$520.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$270.60
|
| Rate for Payer: Oxford Commercial |
$208.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$208.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.56
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
IP
|
$1,040.75
|
|
| Hospital Charge Code |
270679779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.11 |
| Max. Negotiated Rate |
$156.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.11
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
IP
|
$1,253.95
|
|
| Hospital Charge Code |
270637809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.09 |
| Max. Negotiated Rate |
$188.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.09
|
|
|
BIT DRILL 3-FLUTED 3.2x330MM
|
Facility
|
OP
|
$1,253.95
|
|
| Hospital Charge Code |
270637809
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.61 |
| Max. Negotiated Rate |
$626.98 |
| Rate for Payer: Aetna Commercial |
$476.50
|
| Rate for Payer: Aetna Medicare Advantage |
$376.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$319.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$319.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$319.76
|
| Rate for Payer: Cigna Commercial |
$626.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$326.03
|
| Rate for Payer: Oxford Commercial |
$250.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$250.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.61
|
|
|
BIT DRILL 3-FLUTED 3.8x270MM
|
Facility
|
IP
|
$1,100.05
|
|
| Hospital Charge Code |
270651085
|
|
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 3.8x270MM
|
Facility
|
OP
|
$1,100.05
|
|
| Hospital Charge Code |
270651085
|
|
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-FLUTED RAD 3.2x145
|
Facility
|
OP
|
$1,004.25
|
|
| Hospital Charge Code |
270637810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.52 |
| Max. Negotiated Rate |
$502.12 |
| Rate for Payer: Aetna Commercial |
$381.62
|
| Rate for Payer: Aetna Medicare Advantage |
$301.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$256.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$256.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$256.08
|
| Rate for Payer: Cigna Commercial |
$502.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$261.11
|
| Rate for Payer: Oxford Commercial |
$200.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$200.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.52
|
|
|
BIT DRILL 3-FLUTED RAD 3.2x145
|
Facility
|
IP
|
$1,004.25
|
|
| Hospital Charge Code |
270637810
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.64 |
| Max. Negotiated Rate |
$150.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.64
|
|
|
BIT DRILL CANN 10MM TAPERED
|
Facility
|
OP
|
$2,157.85
|
|
| Hospital Charge Code |
270677274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.28 |
| Max. Negotiated Rate |
$1,078.92 |
| Rate for Payer: Aetna Commercial |
$819.98
|
| Rate for Payer: Aetna Medicare Advantage |
$647.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$550.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$550.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$550.25
|
| Rate for Payer: Cigna Commercial |
$1,078.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$561.04
|
| Rate for Payer: Oxford Commercial |
$431.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$323.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$431.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$61.28
|
|
|
BIT DRILL CANN 10MM TAPERED
|
Facility
|
IP
|
$2,157.85
|
|
| Hospital Charge Code |
270677274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$323.68 |
| Max. Negotiated Rate |
$323.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$323.68
|
|
|
BIT DRILL CANN 17.0X300 357851
|
Facility
|
OP
|
$3,306.30
|
|
| Hospital Charge Code |
270633851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.90 |
| Max. Negotiated Rate |
$1,653.15 |
| Rate for Payer: Aetna Commercial |
$1,256.39
|
| Rate for Payer: Aetna Medicare Advantage |
$991.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$843.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$843.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$843.11
|
| Rate for Payer: Cigna Commercial |
$1,653.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$859.64
|
| Rate for Payer: Oxford Commercial |
$661.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$495.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$661.26
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$93.90
|
|
|
BIT DRILL CANN 17.0X300 357851
|
Facility
|
IP
|
$3,306.30
|
|
| Hospital Charge Code |
270633851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$495.94 |
| Max. Negotiated Rate |
$495.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$495.94
|
|
|
BIT DRILL CANN 2.0x150MM STER
|
Facility
|
OP
|
$1,935.00
|
|
| Hospital Charge Code |
270677400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$967.50 |
| Rate for Payer: Aetna Commercial |
$735.30
|
| Rate for Payer: Aetna Medicare Advantage |
$580.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$493.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$493.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$493.43
|
| Rate for Payer: Cigna Commercial |
$967.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$503.10
|
| Rate for Payer: Oxford Commercial |
$387.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$290.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$387.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$61.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$54.95
|
|
|
BIT DRILL CANN 2.0x150MM STER
|
Facility
|
IP
|
$1,935.00
|
|
| Hospital Charge Code |
270677400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$290.25 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$290.25
|
|
|
Bit Drill Cann 5.5
|
Facility
|
OP
|
$1,740.00
|
|
| Hospital Charge Code |
270673705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$870.00 |
| Rate for Payer: Aetna Commercial |
$661.20
|
| Rate for Payer: Aetna Medicare Advantage |
$522.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$443.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$443.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$443.70
|
| Rate for Payer: Cigna Commercial |
$870.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$452.40
|
| Rate for Payer: Oxford Commercial |
$348.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$261.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$348.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.42
|
|
|
Bit Drill Cann 5.5
|
Facility
|
IP
|
$1,740.00
|
|
| Hospital Charge Code |
270673705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$261.00
|
|
|
BIT DRILL CANN FLEX 16MM
|
Facility
|
IP
|
$3,650.60
|
|
| Hospital Charge Code |
270677231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$547.59 |
| Max. Negotiated Rate |
$547.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$547.59
|
|
|
BIT DRILL CANN FLEX 16MM
|
Facility
|
OP
|
$3,650.60
|
|
| Hospital Charge Code |
270677231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$103.68 |
| Max. Negotiated Rate |
$1,825.30 |
| Rate for Payer: Aetna Commercial |
$1,387.23
|
| Rate for Payer: Aetna Medicare Advantage |
$1,095.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$930.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$930.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$930.90
|
| Rate for Payer: Cigna Commercial |
$1,825.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$949.16
|
| Rate for Payer: Oxford Commercial |
$730.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$547.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$730.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$115.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$103.68
|
|