|
CUTTER LINEAR 280MM 45 MM COMP
|
Facility
|
OP
|
$1,664.17
|
|
| Hospital Charge Code |
270690128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$832.09 |
| Rate for Payer: Aetna Commercial |
$632.38
|
| Rate for Payer: Aetna Medicare Advantage |
$499.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.36
|
| Rate for Payer: Cigna Commercial |
$832.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$432.68
|
| Rate for Payer: Oxford Commercial |
$332.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$332.83
|
| Rate for Payer: UnitedHealthcare Community & State |
$52.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.26
|
|
|
CUTTER LINEAR 55 2.5 WH TVC55
|
Facility
|
OP
|
$239.45
|
|
| Hospital Charge Code |
270608733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$119.72 |
| Rate for Payer: Aetna Commercial |
$90.99
|
| Rate for Payer: Aetna Medicare Advantage |
$71.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.06
|
| Rate for Payer: Cigna Commercial |
$119.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$62.26
|
| Rate for Payer: Oxford Commercial |
$47.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.80
|
|
|
CUTTER LINEAR 55 2.5 WH TVC55
|
Facility
|
IP
|
$239.45
|
|
| Hospital Charge Code |
270608733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$35.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.92
|
|
|
CUTTER LINEAR 55MM
|
Facility
|
OP
|
$629.97
|
|
| Hospital Charge Code |
270652020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$314.99 |
| Rate for Payer: Aetna Commercial |
$239.39
|
| Rate for Payer: Aetna Medicare Advantage |
$188.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.64
|
| Rate for Payer: Cigna Commercial |
$314.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$163.79
|
| Rate for Payer: Oxford Commercial |
$125.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$125.99
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.89
|
|
|
CUTTER LINEAR 55MM
|
Facility
|
IP
|
$629.97
|
|
| Hospital Charge Code |
270652020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
|
|
CUTTER LINEAR LOAD UNIT 75MM
|
Facility
|
IP
|
$340.99
|
|
| Hospital Charge Code |
270652018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.15 |
| Max. Negotiated Rate |
$51.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.15
|
|
|
CUTTER LINEAR LOAD UNIT 75MM
|
Facility
|
OP
|
$340.99
|
|
| Hospital Charge Code |
270652018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$170.50 |
| Rate for Payer: Aetna Commercial |
$129.58
|
| Rate for Payer: Aetna Medicare Advantage |
$102.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.95
|
| Rate for Payer: Cigna Commercial |
$170.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$88.66
|
| Rate for Payer: Oxford Commercial |
$68.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$68.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.68
|
|
|
CUTTER LINEAR RELOAD 45mm STD
|
Facility
|
IP
|
$806.04
|
|
| Hospital Charge Code |
270651941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.91 |
| Max. Negotiated Rate |
$120.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.91
|
|
|
CUTTER LINEAR RELOAD 45mm STD
|
Facility
|
OP
|
$806.04
|
|
| Hospital Charge Code |
270651941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$403.02 |
| Rate for Payer: Aetna Commercial |
$306.30
|
| Rate for Payer: Aetna Medicare Advantage |
$241.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$205.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$205.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$205.54
|
| Rate for Payer: Cigna Commercial |
$403.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$209.57
|
| Rate for Payer: Oxford Commercial |
$161.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$161.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.89
|
|
|
CUTTER LINEAR RELOAD 75MM GRN
|
Facility
|
OP
|
$415.13
|
|
| Hospital Charge Code |
270608647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$207.56 |
| Rate for Payer: Aetna Commercial |
$157.75
|
| Rate for Payer: Aetna Medicare Advantage |
$124.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.86
|
| Rate for Payer: Cigna Commercial |
$207.56
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$107.93
|
| Rate for Payer: Oxford Commercial |
$83.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$83.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.79
|
|
|
CUTTER LINEAR RELOAD 75MM GRN
|
Facility
|
IP
|
$415.13
|
|
| Hospital Charge Code |
270608647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$62.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.27
|
|
|
CUTTER LINEAR THCK TISSUE 75MM
|
Facility
|
OP
|
$519.95
|
|
| Hospital Charge Code |
270658426
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.77 |
| Max. Negotiated Rate |
$259.98 |
| Rate for Payer: Aetna Commercial |
$197.58
|
| Rate for Payer: Aetna Medicare Advantage |
$155.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.59
|
| Rate for Payer: Cigna Commercial |
$259.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.19
|
| Rate for Payer: Oxford Commercial |
$103.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.99
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.77
|
|
|
CUTTER LINEAR THCK TISSUE 75MM
|
Facility
|
IP
|
$519.95
|
|
| Hospital Charge Code |
270658426
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.99 |
| Max. Negotiated Rate |
$77.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.99
|
|
|
CUTTER PIN CRANOFIX 2
|
Facility
|
IP
|
$2,147.15
|
|
| Hospital Charge Code |
270684903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$322.07 |
| Max. Negotiated Rate |
$322.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.07
|
|
|
CUTTER PIN CRANOFIX 2
|
Facility
|
OP
|
$2,147.15
|
|
| Hospital Charge Code |
270684903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.98 |
| Max. Negotiated Rate |
$1,073.58 |
| Rate for Payer: Aetna Commercial |
$815.92
|
| Rate for Payer: Aetna Medicare Advantage |
$644.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$547.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$547.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$547.52
|
| Rate for Payer: Cigna Commercial |
$1,073.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$558.26
|
| Rate for Payer: Oxford Commercial |
$429.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$429.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.98
|
|
|
CUTTER POWERD ECH FLEX 60 MM
|
Facility
|
OP
|
$11,118.90
|
|
| Hospital Charge Code |
270662790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$315.78 |
| Max. Negotiated Rate |
$5,559.45 |
| Rate for Payer: Aetna Commercial |
$4,225.18
|
| Rate for Payer: Aetna Medicare Advantage |
$3,335.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,835.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,835.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,835.32
|
| Rate for Payer: Cigna Commercial |
$5,559.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,890.91
|
| Rate for Payer: Oxford Commercial |
$2,223.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,667.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,223.78
|
| Rate for Payer: UnitedHealthcare Community & State |
$351.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$315.78
|
|
|
CUTTER POWERD ECH FLEX 60 MM
|
Facility
|
IP
|
$11,118.90
|
|
| Hospital Charge Code |
270662790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,667.84 |
| Max. Negotiated Rate |
$1,667.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,667.84
|
|
|
CUTTER RESECTOR 5.5mm
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270612085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
CUTTER RESECTOR 5.5mm
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270612085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$72.20
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.40
|
| Rate for Payer: Oxford Commercial |
$38.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.40
|
|
|
CUTTER RESECTOR 5mm
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
270601428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
CUTTER RESECTOR 5mm
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
270601428
|
|
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
|
|
|
CUTTER RESECTOR BONE PLUG 4mm
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270641987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$72.20
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.40
|
| Rate for Payer: Oxford Commercial |
$38.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.40
|
|
|
CUTTER RESECTOR BONE PLUG 4mm
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270641987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
CUTTER SLOTTED WHISKER 4mm
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270619067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$72.20
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.40
|
| Rate for Payer: Oxford Commercial |
$38.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.40
|
|
|
CUTTER SLOTTED WHISKER 4mm
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270619067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|