|
BURR ACORN S 7.5MM HD LGTH 9.5
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674439
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR ACORN S 9MM HD LTH 11.4MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR ACORN S 9MM HD LTH 11.4MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR AGG 2.0MM FLUTED
|
Facility
|
IP
|
$392.85
|
|
| Hospital Charge Code |
270703077
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.93 |
| Max. Negotiated Rate |
$58.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.93
|
|
|
BURR AGG 2.0MM FLUTED
|
Facility
|
OP
|
$392.85
|
|
| Hospital Charge Code |
270703077
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$196.43 |
| Rate for Payer: Aetna Commercial |
$149.28
|
| Rate for Payer: Aetna Medicare Advantage |
$117.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.18
|
| Rate for Payer: Cigna Commercial |
$196.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.14
|
| Rate for Payer: Oxford Commercial |
$78.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$78.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.16
|
|
|
BURR BARREL 6-FLUTE 4mm
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270606567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
BURR BARREL 6-FLUTE 4mm
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
270606567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$76.00
|
| Rate for Payer: Aetna Medicare Advantage |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.00
|
| Rate for Payer: Cigna Commercial |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$52.00
|
| Rate for Payer: Oxford Commercial |
$40.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.68
|
|
|
BURR BARREL L 4MM HD LGTH 9MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL L 4MM HD LGTH 9MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL L 5MM HD LGTH 10MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674460
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL L 5MM HD LGTH 10MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674460
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL L 6MM HD LGTH 11MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL L 6MM HD LGTH 11MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL M 4MM HD LGTH 9MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL M 4MM HD LGTH 9MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL M 5MM HD LGTH 10MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL M 5MM HD LGTH 10MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL M 6MM HD LGTH 11MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL M 6MM HD LGTH 11MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL S 4MM HD LGTH 9MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL S 4MM HD LGTH 9MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL S 5MM HD LGTH 10MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|
|
BURR BARREL S 5MM HD LGTH 10MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL S 6MM HD LGTH 11MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR BARREL S 6MM HD LGTH 11MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$125.02
|
| Rate for Payer: Aetna Medicare Advantage |
$98.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.89
|
| Rate for Payer: Cigna Commercial |
$164.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.54
|
| Rate for Payer: Oxford Commercial |
$65.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.34
|
|