|
BLADE BONE SERRATED 20MM
|
Facility
|
OP
|
$2,025.00
|
|
| Hospital Charge Code |
270663193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.51 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$769.50
|
| Rate for Payer: Aetna Medicare Advantage |
$607.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.38
|
| Rate for Payer: Cigna Commercial |
$1,012.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$526.50
|
| Rate for Payer: Oxford Commercial |
$405.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$405.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.51
|
|
|
BLADE BONE SERRATED 20MM
|
Facility
|
IP
|
$2,025.00
|
|
| Hospital Charge Code |
270663193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
BLADE CAPSULE 4MM
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270679828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
BLADE CAPSULE 4MM
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270679828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$253.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.69
|
|
|
BLADE CARBIDE PUNCH
|
Facility
|
OP
|
$3,375.00
|
|
| Hospital Charge Code |
270680027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Aetna Commercial |
$1,282.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,012.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$860.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$860.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$860.62
|
| Rate for Payer: Cigna Commercial |
$1,687.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$877.50
|
| Rate for Payer: Oxford Commercial |
$675.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$506.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$675.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$106.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$95.85
|
|
|
BLADE CARBIDE PUNCH
|
Facility
|
IP
|
$3,375.00
|
|
| Hospital Charge Code |
270680027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$506.25 |
| Max. Negotiated Rate |
$506.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$506.25
|
|
|
BLADE CHANNELED KING VISION
|
Facility
|
IP
|
$127.85
|
|
| Hospital Charge Code |
270676846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$19.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.18
|
|
|
BLADE CHANNELED KING VISION
|
Facility
|
OP
|
$127.85
|
|
| Hospital Charge Code |
270676846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$63.92 |
| Rate for Payer: Aetna Commercial |
$48.58
|
| Rate for Payer: Aetna Medicare Advantage |
$38.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.60
|
| Rate for Payer: Cigna Commercial |
$63.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.24
|
| Rate for Payer: Oxford Commercial |
$25.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.63
|
|
|
BLADE CHISEL
|
Facility
|
IP
|
$3,500.00
|
|
| Hospital Charge Code |
270686880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
|
|
BLADE CHISEL
|
Facility
|
OP
|
$3,500.00
|
|
| Hospital Charge Code |
270686878
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.40 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,330.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$892.50
|
| Rate for Payer: Cigna Commercial |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$910.00
|
| Rate for Payer: Oxford Commercial |
$700.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$700.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$110.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99.40
|
|
|
BLADE CHISEL
|
Facility
|
IP
|
$3,500.00
|
|
| Hospital Charge Code |
270686878
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
|
|
BLADE CHISEL
|
Facility
|
OP
|
$3,500.00
|
|
| Hospital Charge Code |
270679897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.40 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,330.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$892.50
|
| Rate for Payer: Cigna Commercial |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$910.00
|
| Rate for Payer: Oxford Commercial |
$700.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$700.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$110.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99.40
|
|
|
BLADE CHISEL
|
Facility
|
OP
|
$3,500.00
|
|
| Hospital Charge Code |
270686880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.40 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,330.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,050.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$892.50
|
| Rate for Payer: Cigna Commercial |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$910.00
|
| Rate for Payer: Oxford Commercial |
$700.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$700.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$110.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99.40
|
|
|
BLADE CHISEL
|
Facility
|
IP
|
$3,500.00
|
|
| Hospital Charge Code |
270679897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$525.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$525.00
|
|
|
BLADE COBB ELEV 13MM 11 IN
|
Facility
|
OP
|
$515.45
|
|
| Hospital Charge Code |
270678159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$257.73 |
| Rate for Payer: Aetna Commercial |
$195.87
|
| Rate for Payer: Aetna Medicare Advantage |
$154.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$131.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$131.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$131.44
|
| Rate for Payer: Cigna Commercial |
$257.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$134.02
|
| Rate for Payer: Oxford Commercial |
$103.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.64
|
|
|
BLADE COBB ELEV 13MM 11 IN
|
Facility
|
IP
|
$515.45
|
|
| Hospital Charge Code |
270678159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$77.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.32
|
|
|
BLADE COBB ELEV 25MM 11 IN
|
Facility
|
IP
|
$542.55
|
|
| Hospital Charge Code |
270678160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.38 |
| Max. Negotiated Rate |
$81.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.38
|
|
|
BLADE COBB ELEV 25MM 11 IN
|
Facility
|
OP
|
$542.55
|
|
| Hospital Charge Code |
270678160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.41 |
| Max. Negotiated Rate |
$271.27 |
| Rate for Payer: Aetna Commercial |
$206.17
|
| Rate for Payer: Aetna Medicare Advantage |
$162.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.35
|
| Rate for Payer: Cigna Commercial |
$271.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$141.06
|
| Rate for Payer: Oxford Commercial |
$108.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$108.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.41
|
|
|
BLADE COBB ELEV 9MM 11 IN
|
Facility
|
OP
|
$516.15
|
|
| Hospital Charge Code |
270678158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$258.07 |
| Rate for Payer: Aetna Commercial |
$196.14
|
| Rate for Payer: Aetna Medicare Advantage |
$154.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$131.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$131.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$131.62
|
| Rate for Payer: Cigna Commercial |
$258.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$134.20
|
| Rate for Payer: Oxford Commercial |
$103.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.23
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.66
|
|
|
BLADE COBB ELEV 9MM 11 IN
|
Facility
|
IP
|
$516.15
|
|
| Hospital Charge Code |
270678158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.42 |
| Max. Negotiated Rate |
$77.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.42
|
|
|
BLADE CRANIO CODMAN 26-1246
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270600320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.20
|
| Rate for Payer: Oxford Commercial |
$44.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.25
|
|
|
BLADE CRANIO CODMAN 26-1246
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270600320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
BLADE CURVED 3MM ROUND EDGE
|
Facility
|
IP
|
$804.00
|
|
| Hospital Charge Code |
270675734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.60
|
|
|
BLADE CURVED 3MM ROUND EDGE
|
Facility
|
OP
|
$804.00
|
|
| Hospital Charge Code |
270675734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.83 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: Aetna Commercial |
$305.52
|
| Rate for Payer: Aetna Medicare Advantage |
$241.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$205.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$205.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$205.02
|
| Rate for Payer: Cigna Commercial |
$402.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$209.04
|
| Rate for Payer: Oxford Commercial |
$160.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$160.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.83
|
|
|
BLADE DERMATOME 8800-00-10
|
Facility
|
IP
|
$247.93
|
|
| Hospital Charge Code |
270605722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$37.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.19
|
|