|
BURR CIRCULAR 25MM DIAMOND S
|
Facility
|
IP
|
$465.50
|
|
| Hospital Charge Code |
270674485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.83 |
| Max. Negotiated Rate |
$69.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.83
|
|
|
BURR CIRCULAR 8.0x28MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674564
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CIRCULAR 8.0x28MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674564
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CIRCULAR 8x28MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CIRCULAR 8x28MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR, CONICAL
|
Facility
|
IP
|
$1,802.50
|
|
| Hospital Charge Code |
270701991
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$270.38 |
| Max. Negotiated Rate |
$270.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$270.38
|
|
|
BURR, CONICAL
|
Facility
|
OP
|
$1,802.50
|
|
| Hospital Charge Code |
270701991
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$51.19 |
| Max. Negotiated Rate |
$901.25 |
| Rate for Payer: Aetna Commercial |
$684.95
|
| Rate for Payer: Aetna Medicare Advantage |
$540.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$459.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$459.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$459.64
|
| Rate for Payer: Cigna Commercial |
$901.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$468.65
|
| Rate for Payer: Oxford Commercial |
$360.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$270.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$360.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$56.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$51.19
|
|
|
BURR CONICAL 5x23MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL 5x23MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL 5x28MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL 5x28MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL 5x45MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674549
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL 5x45MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674549
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL 6x24MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL 6x24MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL 6x28MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL 6x28MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL 6x45MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL 6x45MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL LGTH 23x5MM J-LAT
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674596
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL LGTH 23x5MM J-LAT
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674596
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL LGTH 24x6MM J-LAT
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL LGTH 24x6MM J-LAT
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR CONICAL LGTH 28x5MM J-LAT
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$190.75 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare Advantage |
$114.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$97.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$97.28
|
| Rate for Payer: Cigna Commercial |
$190.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.19
|
| Rate for Payer: Oxford Commercial |
$76.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.83
|
|
|
BURR CONICAL LGTH 28x5MM J-LAT
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|