|
BUR ROUND 6.3MM FAST CUTTING
|
Facility
|
OP
|
$305.00
|
|
| Hospital Charge Code |
270681355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$115.90
|
| Rate for Payer: Aetna Medicare Advantage |
$91.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.78
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.30
|
| Rate for Payer: Oxford Commercial |
$61.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.66
|
|
|
BUR ROUND 6.3MM FAST CUTTING
|
Facility
|
IP
|
$305.00
|
|
| Hospital Charge Code |
270681355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$45.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
BUR ROUND CARBIDE LONG 6.5MM
|
Facility
|
OP
|
$109.85
|
|
| Hospital Charge Code |
270647601
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$54.92 |
| Rate for Payer: Aetna Commercial |
$41.74
|
| Rate for Payer: Aetna Medicare Advantage |
$32.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.01
|
| Rate for Payer: Cigna Commercial |
$54.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.56
|
| Rate for Payer: Oxford Commercial |
$21.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
BUR ROUND CARBIDE LONG 6.5MM
|
Facility
|
IP
|
$109.85
|
|
| Hospital Charge Code |
270647601
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.48 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.48
|
|
|
BUR ROUND POL 4x54MM FLUTES 25
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
270673336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.80
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.95
|
|
|
BUR ROUND POL 4x54MM FLUTES 25
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
270673336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|
|
BUR ROUTER STR 1.1MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270672707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BUR ROUTER STR 1.1MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270672707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.64 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$235.98
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.46
|
| Rate for Payer: Oxford Commercial |
$124.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.64
|
|
|
BUR ROUTER TAPERED 1.5MM
|
Facility
|
OP
|
$620.00
|
|
| Hospital Charge Code |
270676896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Aetna Commercial |
$235.60
|
| Rate for Payer: Aetna Medicare Advantage |
$186.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.10
|
| Rate for Payer: Cigna Commercial |
$310.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.20
|
| Rate for Payer: Oxford Commercial |
$124.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.61
|
|
|
BUR ROUTER TAPERED 1.5MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270677192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BUR ROUTER TAPERED 1.5MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270677192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.64 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$235.98
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.46
|
| Rate for Payer: Oxford Commercial |
$124.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.64
|
|
|
BUR ROUTER TAPERED 1.5MM
|
Facility
|
IP
|
$620.00
|
|
| Hospital Charge Code |
270676896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.00 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.00
|
|
|
BUR ROUTER TAPERED 2.5MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270672708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BUR ROUTER TAPERED 2.5MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270672708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.64 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$235.98
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.46
|
| Rate for Payer: Oxford Commercial |
$124.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.64
|
|
|
BUR ROUTER TAPERED 3MM
|
Facility
|
OP
|
$621.00
|
|
| Hospital Charge Code |
270672705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.64 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$235.98
|
| Rate for Payer: Aetna Medicare Advantage |
$186.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.35
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.46
|
| Rate for Payer: Oxford Commercial |
$124.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.64
|
|
|
BUR ROUTER TAPERED 3MM
|
Facility
|
IP
|
$621.00
|
|
| Hospital Charge Code |
270672705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$93.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.15
|
|
|
BURR OVAL 8 FLUTE 4.0MM
|
Facility
|
OP
|
$295.00
|
|
| Hospital Charge Code |
270688424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| Rate for Payer: Aetna Medicare Advantage |
$88.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.22
|
| Rate for Payer: Cigna Commercial |
$147.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.70
|
| Rate for Payer: Oxford Commercial |
$59.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.38
|
|
|
BURR OVAL 8 FLUTE 4.0MM
|
Facility
|
IP
|
$295.00
|
|
| Hospital Charge Code |
270688424
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$44.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
|
|
BURR OVAL CARBIDE 4X69.9MM
|
Facility
|
OP
|
$205.75
|
|
| Hospital Charge Code |
270674221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$102.88 |
| Rate for Payer: Aetna Commercial |
$78.19
|
| Rate for Payer: Aetna Medicare Advantage |
$61.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.47
|
| Rate for Payer: Cigna Commercial |
$102.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.49
|
| Rate for Payer: Oxford Commercial |
$41.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$41.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.84
|
|
|
BURR OVAL CARBIDE 4X69.9MM
|
Facility
|
IP
|
$205.75
|
|
| Hospital Charge Code |
270674221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.86 |
| Max. Negotiated Rate |
$30.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.86
|
|
|
BURR OVAL FLUTE 4 MM 13 CM
|
Facility
|
OP
|
$295.00
|
|
| Hospital Charge Code |
270688458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| Rate for Payer: Aetna Medicare Advantage |
$88.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.22
|
| Rate for Payer: Cigna Commercial |
$147.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.70
|
| Rate for Payer: Oxford Commercial |
$59.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.38
|
|
|
BURR OVAL FLUTE 4 MM 13 CM
|
Facility
|
IP
|
$295.00
|
|
| Hospital Charge Code |
270688458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$44.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
|
|
BURR OVAL FLUTE 8
|
Facility
|
OP
|
$1,475.00
|
|
| Hospital Charge Code |
270694341
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$383.50
|
| Rate for Payer: Oxford Commercial |
$295.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$295.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.89
|
|
|
BURR OVAL FLUTE 8
|
Facility
|
IP
|
$1,475.00
|
|
| Hospital Charge Code |
270694341
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$221.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
BURR PEAR 5.0MMx23MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674553
|
|
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
|
|