|
ELECTRODE S50 VAPR
|
Facility
|
IP
|
$1,180.00
|
|
| Hospital Charge Code |
270657366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$177.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$177.00
|
|
|
ELECTRODE SAFEOP EMG KIT
|
Facility
|
OP
|
$6,600.00
|
|
| Hospital Charge Code |
270698069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$159.06 |
| Max. Negotiated Rate |
$3,300.00 |
| Rate for Payer: Aetna Commercial |
$2,508.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,980.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,683.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,683.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,683.00
|
| Rate for Payer: Cigna Commercial |
$3,300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,980.00
|
| Rate for Payer: Oxford Commercial |
$1,320.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,320.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$159.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$174.90
|
|
|
ELECTRODE SAFEOP EMG KIT
|
Facility
|
IP
|
$6,600.00
|
|
| Hospital Charge Code |
270698069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$990.00 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.00
|
|
|
ELECTRODE SELF ADHES 406650205
|
Facility
|
OP
|
$125.00
|
|
| Hospital Charge Code |
270641685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$62.50 |
| Rate for Payer: Aetna Commercial |
$47.50
|
| Rate for Payer: Aetna Medicare Advantage |
$37.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.88
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.50
|
| Rate for Payer: Oxford Commercial |
$25.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.31
|
|
|
ELECTRODE SELF ADHES 406650205
|
Facility
|
IP
|
$125.00
|
|
| Hospital Charge Code |
270641685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
ELECTRODE SMALL LOOP ******
|
Facility
|
OP
|
$58.00
|
|
| Hospital Charge Code |
1608157
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$29.00 |
| Rate for Payer: Aetna Commercial |
$22.04
|
| Rate for Payer: Aetna Medicare Advantage |
$17.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.79
|
| Rate for Payer: Cigna Commercial |
$29.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.40
|
| Rate for Payer: Oxford Commercial |
$11.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.54
|
|
|
ELECTRODE SMALL LOOP ******
|
Facility
|
IP
|
$58.00
|
|
| Hospital Charge Code |
1608157
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.70 |
| Max. Negotiated Rate |
$8.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.70
|
|
|
ELECTRODE SOLID GEL DI
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
270600754
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.52
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.20
|
| Rate for Payer: Oxford Commercial |
$0.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.11
|
|
|
ELECTRODE SOLID GEL DI
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
270600754
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
ELECTRODE SPLIT ADULT RETURN
|
Facility
|
OP
|
$34.75
|
|
| Hospital Charge Code |
270636745
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$17.38 |
| Rate for Payer: Aetna Commercial |
$13.21
|
| Rate for Payer: Aetna Medicare Advantage |
$10.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.86
|
| Rate for Payer: Cigna Commercial |
$17.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.43
|
| Rate for Payer: Oxford Commercial |
$6.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.92
|
|
|
ELECTRODE SPLIT ADULT RETURN
|
Facility
|
IP
|
$34.75
|
|
| Hospital Charge Code |
270636745
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$5.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.21
|
|
|
ELECTRODE SS BALL 5MM DIA
|
Facility
|
OP
|
$68.78
|
|
| Hospital Charge Code |
270676242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$34.39 |
| Rate for Payer: Aetna Commercial |
$26.14
|
| Rate for Payer: Aetna Medicare Advantage |
$20.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.54
|
| Rate for Payer: Cigna Commercial |
$34.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.63
|
| Rate for Payer: Oxford Commercial |
$13.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.76
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.82
|
|
|
ELECTRODE SS BALL 5MM DIA
|
Facility
|
IP
|
$68.78
|
|
| Hospital Charge Code |
270676242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$10.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.32
|
|
|
ELECTRODE STRESS TEST 20X50***
|
Facility
|
OP
|
$21.00
|
|
| Hospital Charge Code |
270090035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$7.98
|
| Rate for Payer: Aetna Medicare Advantage |
$6.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.36
|
| Rate for Payer: Cigna Commercial |
$10.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.30
|
| Rate for Payer: Oxford Commercial |
$4.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.56
|
|
|
ELECTRODE STRESS TEST 20X50***
|
Facility
|
IP
|
$21.00
|
|
| Hospital Charge Code |
270090035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$3.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
ELECTRODES TSN EKG****
|
Facility
|
IP
|
$94.00
|
|
| Hospital Charge Code |
1800218
|
|
Hospital Revenue Code
|
739
|
| Min. Negotiated Rate |
$14.10 |
| Max. Negotiated Rate |
$14.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.10
|
|
|
ELECTRODES TSN EKG****
|
Facility
|
OP
|
$94.00
|
|
| Hospital Charge Code |
1800218
|
|
Hospital Revenue Code
|
739
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Aetna Commercial |
$35.72
|
| Rate for Payer: Aetna Medicare Advantage |
$28.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.97
|
| Rate for Payer: Cigna Commercial |
$47.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.20
|
| Rate for Payer: Oxford Commercial |
$531.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.49
|
|
|
ELECTRODE STZ COAG 24F 27050L
|
Facility
|
IP
|
$477.66
|
|
| Hospital Charge Code |
270627179
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.65 |
| Max. Negotiated Rate |
$71.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.65
|
|
|
ELECTRODE STZ COAG 24F 27050L
|
Facility
|
OP
|
$477.66
|
|
| Hospital Charge Code |
270627179
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$238.83 |
| Rate for Payer: Aetna Commercial |
$181.51
|
| Rate for Payer: Aetna Medicare Advantage |
$143.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121.80
|
| Rate for Payer: Cigna Commercial |
$238.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.30
|
| Rate for Payer: Oxford Commercial |
$95.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.66
|
|
|
ELECTRODES VITALSTIM SDULT
|
Facility
|
OP
|
$87.08
|
|
| Hospital Charge Code |
270663475
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna Commercial |
$33.09
|
| Rate for Payer: Aetna Medicare Advantage |
$26.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.21
|
| Rate for Payer: Cigna Commercial |
$43.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.12
|
| Rate for Payer: Oxford Commercial |
$17.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.31
|
|
|
ELECTRODES VITALSTIM SDULT
|
Facility
|
IP
|
$87.08
|
|
| Hospital Charge Code |
270663475
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$13.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.06
|
|
|
ELECTRODES XMD SUBDERM 8227410
|
Facility
|
IP
|
$362.45
|
|
| Hospital Charge Code |
270621428
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.37 |
| Max. Negotiated Rate |
$54.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.37
|
|
|
ELECTRODES XMD SUBDERM 8227410
|
Facility
|
OP
|
$362.45
|
|
| Hospital Charge Code |
270621428
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$181.22 |
| Rate for Payer: Aetna Commercial |
$137.73
|
| Rate for Payer: Aetna Medicare Advantage |
$108.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.42
|
| Rate for Payer: Cigna Commercial |
$181.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$108.73
|
| Rate for Payer: Oxford Commercial |
$72.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.49
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.60
|
|
|
ELECTRODES ZOLL8900-4003 TIER3
|
Facility
|
IP
|
$93.27
|
|
| Hospital Charge Code |
270102159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$13.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.99
|
|
|
ELECTRODES ZOLL8900-4003 TIER3
|
Facility
|
OP
|
$93.27
|
|
| Hospital Charge Code |
270102159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$46.63 |
| Rate for Payer: Aetna Commercial |
$35.44
|
| Rate for Payer: Aetna Medicare Advantage |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.78
|
| Rate for Payer: Cigna Commercial |
$46.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.98
|
| Rate for Payer: Oxford Commercial |
$18.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.47
|
|