|
ELECTRODE QUICK PACE PACE*****
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
8003212
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
ELECTRODE QUICK PACE PACE*****
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
8003212
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$4.82 |
| 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 |
$60.00
|
| 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 |
$4.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.30
|
|
|
ELECTRODE QUICK-PACE PACE*****
|
Facility
|
IP
|
$183.00
|
|
| Hospital Charge Code |
8009979
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$27.45 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.45
|
|
|
ELECTRODE QUICK-PACE PACE*****
|
Facility
|
OP
|
$183.00
|
|
| Hospital Charge Code |
8009979
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Aetna Commercial |
$69.54
|
| Rate for Payer: Aetna Medicare Advantage |
$54.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.66
|
| Rate for Payer: Cigna Commercial |
$91.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.90
|
| Rate for Payer: Oxford Commercial |
$36.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.85
|
|
|
ELECTRODE QUICK-PACE PEDIATRIC
|
Facility
|
OP
|
$195.80
|
|
| Hospital Charge Code |
270613039
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$97.90 |
| Rate for Payer: Aetna Commercial |
$74.40
|
| Rate for Payer: Aetna Medicare Advantage |
$58.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.93
|
| Rate for Payer: Cigna Commercial |
$97.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.74
|
| Rate for Payer: Oxford Commercial |
$39.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$39.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.19
|
|
|
ELECTRODE QUICK-PACE PEDIATRIC
|
Facility
|
IP
|
$195.80
|
|
| Hospital Charge Code |
270613039
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$29.37 |
| Max. Negotiated Rate |
$29.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.37
|
|
|
ELECTRODE QUIK-COMBO PEDIATRIC
|
Facility
|
IP
|
$119.45
|
|
| Hospital Charge Code |
270641046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$17.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.92
|
|
|
ELECTRODE QUIK-COMBO PEDIATRIC
|
Facility
|
OP
|
$119.45
|
|
| Hospital Charge Code |
270641046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$59.73 |
| Rate for Payer: Aetna Commercial |
$45.39
|
| Rate for Payer: Aetna Medicare Advantage |
$35.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.46
|
| Rate for Payer: Cigna Commercial |
$59.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.84
|
| Rate for Payer: Oxford Commercial |
$23.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.17
|
|
|
ELECTRODE RADIOFREQUENCY CURVE
|
Facility
|
OP
|
$55.60
|
|
| Hospital Charge Code |
270657281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$27.80 |
| Rate for Payer: Aetna Commercial |
$21.13
|
| Rate for Payer: Aetna Medicare Advantage |
$16.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.18
|
| Rate for Payer: Cigna Commercial |
$27.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.68
|
| Rate for Payer: Oxford Commercial |
$11.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.47
|
|
|
ELECTRODE RADIOFREQUENCY CURVE
|
Facility
|
IP
|
$55.60
|
|
| Hospital Charge Code |
270657281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$8.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.34
|
|
|
ELECTRODE RBALL 27F LG 27050MK
|
Facility
|
OP
|
$409.25
|
|
| Hospital Charge Code |
270601219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$204.62 |
| Rate for Payer: Aetna Commercial |
$155.51
|
| Rate for Payer: Aetna Medicare Advantage |
$122.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104.36
|
| Rate for Payer: Cigna Commercial |
$204.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$122.78
|
| Rate for Payer: Oxford Commercial |
$81.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$81.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.85
|
|
|
ELECTRODE RBALL 27F LG 27050MK
|
Facility
|
IP
|
$409.25
|
|
| Hospital Charge Code |
270601219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.39 |
| Max. Negotiated Rate |
$61.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.39
|
|
|
ELECTRODE RED DOT PEDIATRIC
|
Facility
|
OP
|
$144.00
|
|
| Hospital Charge Code |
270610520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$54.72
|
| Rate for Payer: Aetna Medicare Advantage |
$43.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.72
|
| Rate for Payer: Cigna Commercial |
$72.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.20
|
| Rate for Payer: Oxford Commercial |
$28.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$28.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.82
|
|
|
ELECTRODE RED DOT PEDIATRIC
|
Facility
|
IP
|
$144.00
|
|
| Hospital Charge Code |
270610520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
ELECTRODE RED RADIO 4509002570
|
Facility
|
IP
|
$1.25
|
|
| Hospital Charge Code |
270626905
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.19
|
|
|
ELECTRODE RED RADIO 4509002570
|
Facility
|
OP
|
$1.25
|
|
| Hospital Charge Code |
270626905
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.63 |
| Rate for Payer: Aetna Commercial |
$0.48
|
| Rate for Payer: Aetna Medicare Advantage |
$0.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.32
|
| Rate for Payer: Cigna Commercial |
$0.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.38
|
| Rate for Payer: Oxford Commercial |
$0.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.03
|
|
|
ELECTRODE RESECTASCOPE LOOP
|
Facility
|
IP
|
$247.50
|
|
| Hospital Charge Code |
270618275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|
|
ELECTRODE RESECTASCOPE LOOP
|
Facility
|
OP
|
$247.50
|
|
| Hospital Charge Code |
270618275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$94.05
|
| Rate for Payer: Aetna Medicare Advantage |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.11
|
| Rate for Payer: Cigna Commercial |
$123.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.25
|
| Rate for Payer: Oxford Commercial |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.56
|
|
|
ELECTRODE RETURN 400-2100
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
270638372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
|
|
ELECTRODE RETURN 400-2100
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
270638372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Medicare Advantage |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.75
|
| Rate for Payer: Cigna Commercial |
$25.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.00
|
| Rate for Payer: Oxford Commercial |
$10.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.32
|
|
|
ELECTRODE ROLLER BALL
|
Facility
|
OP
|
$499.17
|
|
| Hospital Charge Code |
270655414
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.03 |
| Max. Negotiated Rate |
$249.59 |
| Rate for Payer: Aetna Commercial |
$189.68
|
| Rate for Payer: Aetna Medicare Advantage |
$149.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.29
|
| Rate for Payer: Cigna Commercial |
$249.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.75
|
| Rate for Payer: Oxford Commercial |
$99.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.83
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.23
|
|
|
ELECTRODE ROLLER BALL
|
Facility
|
IP
|
$499.17
|
|
| Hospital Charge Code |
270655414
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$74.88 |
| Max. Negotiated Rate |
$74.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.88
|
|
|
ELECTRODE ROLLERBALL SM N24CH
|
Facility
|
IP
|
$1,209.65
|
|
| Hospital Charge Code |
270601220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$181.45 |
| Max. Negotiated Rate |
$181.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.45
|
|
|
ELECTRODE ROLLERBALL SM N24CH
|
Facility
|
OP
|
$1,209.65
|
|
| Hospital Charge Code |
270601220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.15 |
| Max. Negotiated Rate |
$604.83 |
| Rate for Payer: Aetna Commercial |
$459.67
|
| Rate for Payer: Aetna Medicare Advantage |
$362.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.46
|
| Rate for Payer: Cigna Commercial |
$604.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$362.89
|
| Rate for Payer: Oxford Commercial |
$241.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$181.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$241.93
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.06
|
|
|
ELECTRODE S50 VAPR
|
Facility
|
OP
|
$1,180.00
|
|
| Hospital Charge Code |
270657366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.44 |
| Max. Negotiated Rate |
$590.00 |
| Rate for Payer: Aetna Commercial |
$448.40
|
| Rate for Payer: Aetna Medicare Advantage |
$354.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$300.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$300.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$300.90
|
| Rate for Payer: Cigna Commercial |
$590.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.00
|
| Rate for Payer: Oxford Commercial |
$236.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$177.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$236.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.27
|
|