|
BURR PEAR 5.0MMx23MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR 5.0MMx28MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR 5.0MMx28MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674554
|
|
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 PEAR 5.0MMx45MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674555
|
|
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 PEAR 5.0MMx45MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR 6.0MMx24MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR 6.0MMx24MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674556
|
|
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 PEAR 6.0MMx28MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674558
|
|
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 PEAR 6.0MMx28MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674558
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR 6.0MMx45MM MINI QC
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674559
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR 6.0MMx45MM MINI QC
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674559
|
|
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 PEAR L 4MM HD LGTH 6.9MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674625
|
|
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 PEAR L 4MM HD LGTH 6.9MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR L 5MM HD LGTH 8.3MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674454
|
|
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 PEAR L 5MM HD LGTH 8.3MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674454
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR L 6MM HD LGTH 9.7MM
|
Facility
|
IP
|
$329.00
|
|
| Hospital Charge Code |
270674457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
BURR PEAR L 6MM HD LGTH 9.7MM
|
Facility
|
OP
|
$329.00
|
|
| Hospital Charge Code |
270674457
|
|
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 PEAR LGTH 23x5MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 23x5MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674602
|
|
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 PEAR LGTH 24x6MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674605
|
|
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 PEAR LGTH 24x6MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 28x5MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674603
|
|
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 PEAR LGTH 28x5MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674603
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 28x6MM J-LATCH
|
Facility
|
IP
|
$381.50
|
|
| Hospital Charge Code |
270674606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.23 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.23
|
|
|
BURR PEAR LGTH 28x6MM J-LATCH
|
Facility
|
OP
|
$381.50
|
|
| Hospital Charge Code |
270674606
|
|
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
|
|