|
HEPARIN LOCK FLUSH/100U/M
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
60634541
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
HEPARIN SODIUM/10000U/1ML
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60633083
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.66
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
HEPARIN SODIUM/10000U/1ML
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60633086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.69 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
HEPARIN SODIUM/10000U/1ML
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60633083
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.69 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
HEPARIN SODIUM/10000U/1ML
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60633086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.66
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
HEPARIN SODIUM/1000U/1ML
|
Facility
|
IP
|
$18.00
|
|
| Hospital Charge Code |
60633088
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$4.36 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.70
|
|
|
HEPARIN SODIUM/1000U/1ML
|
Facility
|
OP
|
$18.00
|
|
| Hospital Charge Code |
60633088
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$6.84
|
| Rate for Payer: Aetna Medicare Advantage |
$5.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.59
|
| Rate for Payer: Cigna Commercial |
$9.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.48
|
|
|
HEPARIN SODIUM/1000U/1ML
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60633085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.69 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
HEPARIN SODIUM/1000U/1ML
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60633085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.66
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
Heparin Sodium 1000units/1mL v
|
Facility
|
IP
|
$45.63
|
|
| Hospital Charge Code |
4509074
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$11.04 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.84
|
|
|
Heparin Sodium 1000units/1mL v
|
Facility
|
OP
|
$45.63
|
|
| Hospital Charge Code |
4509074
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$22.82 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare Advantage |
$13.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.64
|
| Rate for Payer: Cigna Commercial |
$22.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.84
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.21
|
|
|
HEPARIN SODIUM/20000U/1ML
|
Facility
|
IP
|
$13.00
|
|
| Hospital Charge Code |
60633087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$3.15 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.95
|
|
|
HEPARIN SODIUM/20000U/1ML
|
Facility
|
OP
|
$13.00
|
|
| Hospital Charge Code |
60633087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$4.94
|
| Rate for Payer: Aetna Medicare Advantage |
$3.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.31
|
| Rate for Payer: Cigna Commercial |
$6.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|
|
HEPARIN SODIUM/5000U/1ML
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60633084
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.66
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
HEPARIN SODIUM/5000U/1ML
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60633084
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.69 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
HEPARIN SODIUM/5000U/1ML
|
Facility
|
IP
|
$5.00
|
|
| Hospital Charge Code |
60633089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
|
|
HEPARIN SODIUM/5000U/1ML
|
Facility
|
OP
|
$5.00
|
|
| Hospital Charge Code |
60633089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna Commercial |
$1.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.27
|
| Rate for Payer: Cigna Commercial |
$2.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.13
|
|
|
HEPARIN SOD PORC 1000U/ML 30ML
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
6063943204
|
|
Hospital Revenue Code
|
636
|
| 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 |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.11
|
|
|
HEPARIN SOD PORC 1000U/ML 30ML
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
6063943204
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
HEPARIN TUBEX 10,000U
|
Facility
|
IP
|
$10.90
|
|
| Hospital Charge Code |
6012629
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.64
|
|
|
HEPARIN TUBEX 10,000U
|
Facility
|
OP
|
$10.90
|
|
| Hospital Charge Code |
6012629
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$5.45 |
| Rate for Payer: Aetna Commercial |
$4.14
|
| Rate for Payer: Aetna Medicare Advantage |
$3.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.78
|
| Rate for Payer: Cigna Commercial |
$5.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.27
|
| Rate for Payer: Oxford Commercial |
$2.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.29
|
|
|
HEPARIN VL 1000U
|
Facility
|
IP
|
$7.70
|
|
| Hospital Charge Code |
6015028
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
|
|
HEPARIN VL 1000U
|
Facility
|
OP
|
$7.70
|
|
| Hospital Charge Code |
6015028
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$3.85 |
| Rate for Payer: Aetna Commercial |
$2.93
|
| Rate for Payer: Aetna Medicare Advantage |
$2.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.96
|
| Rate for Payer: Cigna Commercial |
$3.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.31
|
| Rate for Payer: Oxford Commercial |
$1.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.20
|
|
|
HEPARIN VL 5000U/ML 10ML
|
Facility
|
OP
|
$19.85
|
|
| Hospital Charge Code |
6010177
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$9.93 |
| Rate for Payer: Aetna Commercial |
$7.54
|
| Rate for Payer: Aetna Medicare Advantage |
$5.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.06
|
| Rate for Payer: Cigna Commercial |
$9.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.96
|
| Rate for Payer: Oxford Commercial |
$3.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.53
|
|
|
HEPARIN VL 5000U/ML 10ML
|
Facility
|
IP
|
$19.85
|
|
| Hospital Charge Code |
6010177
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.98
|
|