|
AIRWAY NASAL PVC 22FR
|
Facility
|
OP
|
$27.95
|
|
| Hospital Charge Code |
270676807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$13.97 |
| Rate for Payer: Aetna Commercial |
$10.62
|
| Rate for Payer: Aetna Medicare Advantage |
$8.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.13
|
| Rate for Payer: Cigna Commercial |
$13.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.38
|
| Rate for Payer: Oxford Commercial |
$5.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.59
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.74
|
|
|
AIRWAY NASAL PVC 24FR
|
Facility
|
OP
|
$26.00
|
|
| Hospital Charge Code |
270676808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$9.88
|
| Rate for Payer: Aetna Medicare Advantage |
$7.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.63
|
| Rate for Payer: Cigna Commercial |
$13.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.80
|
| Rate for Payer: Oxford Commercial |
$5.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.69
|
|
|
AIRWAY NASAL PVC 24FR
|
Facility
|
IP
|
$26.00
|
|
| Hospital Charge Code |
270676808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
|
|
AIRWAY NASAL PVC LF 26FR
|
Facility
|
OP
|
$16.25
|
|
| Hospital Charge Code |
270638748
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$8.12 |
| Rate for Payer: Aetna Commercial |
$6.17
|
| Rate for Payer: Aetna Medicare Advantage |
$4.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.14
|
| Rate for Payer: Cigna Commercial |
$8.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.88
|
| Rate for Payer: Oxford Commercial |
$3.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.43
|
|
|
AIRWAY NASAL PVC LF 26FR
|
Facility
|
IP
|
$16.25
|
|
| Hospital Charge Code |
270638748
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.44
|
|
|
AIRWAY NASAL PVC LF 36FR
|
Facility
|
IP
|
$17.72
|
|
| Hospital Charge Code |
270638749
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.66 |
| Max. Negotiated Rate |
$2.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.66
|
|
|
AIRWAY NASAL PVC LF 36FR
|
Facility
|
OP
|
$17.72
|
|
| Hospital Charge Code |
270638749
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna Commercial |
$6.73
|
| Rate for Payer: Aetna Medicare Advantage |
$5.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.52
|
| Rate for Payer: Cigna Commercial |
$8.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.32
|
| Rate for Payer: Oxford Commercial |
$3.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.47
|
|
|
AIRWAY NASOPHAR 22FR A4N156274
|
Facility
|
OP
|
$26.35
|
|
| Hospital Charge Code |
270627035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Aetna Commercial |
$10.01
|
| Rate for Payer: Aetna Medicare Advantage |
$7.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.72
|
| Rate for Payer: Cigna Commercial |
$13.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.91
|
| Rate for Payer: Oxford Commercial |
$5.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.70
|
|
|
AIRWAY NASOPHAR 22FR A4N156274
|
Facility
|
IP
|
$26.35
|
|
| Hospital Charge Code |
270627035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$3.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.95
|
|
|
AIRWAY NASOPHAR 36FR A4N1C6274
|
Facility
|
OP
|
$27.15
|
|
| Hospital Charge Code |
270627043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$13.57 |
| Rate for Payer: Aetna Commercial |
$10.32
|
| Rate for Payer: Aetna Medicare Advantage |
$8.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.92
|
| Rate for Payer: Cigna Commercial |
$13.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.14
|
| Rate for Payer: Oxford Commercial |
$5.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.72
|
|
|
AIRWAY NASOPHAR 36FR A4N1C6274
|
Facility
|
IP
|
$27.15
|
|
| Hospital Charge Code |
270627043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$4.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.07
|
|
|
AIRWAY NASOPHARTNG 34FR 123034
|
Facility
|
OP
|
$20.27
|
|
| Hospital Charge Code |
270651075
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$10.13 |
| Rate for Payer: Aetna Commercial |
$7.70
|
| Rate for Payer: Aetna Medicare Advantage |
$6.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.17
|
| Rate for Payer: Cigna Commercial |
$10.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.08
|
| Rate for Payer: Oxford Commercial |
$4.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.54
|
|
|
AIRWAY NASOPHARTNG 34FR 123034
|
Facility
|
IP
|
$20.27
|
|
| Hospital Charge Code |
270651075
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$3.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
|
|
AIRWAY NASOPHARYN
|
Facility
|
OP
|
$44.84
|
|
| Hospital Charge Code |
270600863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$22.42 |
| Rate for Payer: Aetna Commercial |
$17.04
|
| Rate for Payer: Aetna Medicare Advantage |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.43
|
| Rate for Payer: Cigna Commercial |
$22.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.45
|
| Rate for Payer: Oxford Commercial |
$8.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.19
|
|
|
AIRWAY NASOPHARYN
|
Facility
|
IP
|
$44.84
|
|
| Hospital Charge Code |
270600863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$6.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
|
|
AIRWAY NASOPHARYN 28 FR
|
Facility
|
IP
|
$44.41
|
|
| Hospital Charge Code |
270600862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$6.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
|
|
AIRWAY NASOPHARYN 28 FR
|
Facility
|
OP
|
$44.41
|
|
| Hospital Charge Code |
270600862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$22.20 |
| Rate for Payer: Aetna Commercial |
$16.88
|
| Rate for Payer: Aetna Medicare Advantage |
$13.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.32
|
| Rate for Payer: Cigna Commercial |
$22.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.32
|
| Rate for Payer: Oxford Commercial |
$8.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.88
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.18
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
IP
|
$37.65
|
|
| Hospital Charge Code |
270600604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$5.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
OP
|
$37.65
|
|
| Hospital Charge Code |
270600604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: Aetna Medicare Advantage |
$11.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.60
|
| Rate for Payer: Cigna Commercial |
$18.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.29
|
| Rate for Payer: Oxford Commercial |
$7.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.00
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
OP
|
$44.41
|
|
| Hospital Charge Code |
270600860
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$22.20 |
| Rate for Payer: Aetna Commercial |
$16.88
|
| Rate for Payer: Aetna Medicare Advantage |
$13.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.32
|
| Rate for Payer: Cigna Commercial |
$22.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.32
|
| Rate for Payer: Oxford Commercial |
$8.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.88
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.18
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
IP
|
$44.41
|
|
| Hospital Charge Code |
270600860
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$6.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
IP
|
$17.91
|
|
| Hospital Charge Code |
270601170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$2.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.69
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
IP
|
$117.65
|
|
| Hospital Charge Code |
270600859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
OP
|
$117.65
|
|
| Hospital Charge Code |
270600859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$58.83 |
| Rate for Payer: Aetna Commercial |
$44.71
|
| Rate for Payer: Aetna Medicare Advantage |
$35.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.00
|
| Rate for Payer: Cigna Commercial |
$58.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.30
|
| Rate for Payer: Oxford Commercial |
$23.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
OP
|
$17.91
|
|
| Hospital Charge Code |
270601170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$8.96 |
| Rate for Payer: Aetna Commercial |
$6.81
|
| Rate for Payer: Aetna Medicare Advantage |
$5.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.57
|
| Rate for Payer: Cigna Commercial |
$8.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.37
|
| Rate for Payer: Oxford Commercial |
$3.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.47
|
|