|
MORPHINE SULF LIQ 0.2MG/0.1 ML
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 54023749
|
| Hospital Charge Code |
606350974
|
|
Hospital Revenue Code
|
250
|
| 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
|
|
|
MORPHINE SULF LIQ 0.2MG/0.1 ML
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 54023749
|
| Hospital Charge Code |
606350974
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
MORPHINE TAB SOLUBLE 10MG
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
60627712
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Aetna Commercial |
$1.22
|
| Rate for Payer: Aetna Medicare Advantage |
$0.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.82
|
| Rate for Payer: Cigna Commercial |
$1.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.96
|
| Rate for Payer: Oxford Commercial |
$0.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.08
|
|
|
MORPHINE TAB SOLUBLE 10MG
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
60627712
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.48
|
|
|
MORPHINE TAB SOLUBLE 30MG
|
Facility
|
IP
|
$4.50
|
|
| Hospital Charge Code |
60627718
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.68
|
|
|
MORPHINE TAB SOLUBLE 30MG
|
Facility
|
OP
|
$4.50
|
|
| Hospital Charge Code |
60627718
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Aetna Commercial |
$1.71
|
| Rate for Payer: Aetna Medicare Advantage |
$1.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.15
|
| Rate for Payer: Cigna Commercial |
$2.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.35
|
| Rate for Payer: Oxford Commercial |
$0.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.12
|
|
|
MORPHINE TAB SR 100MG
|
Facility
|
OP
|
$32.65
|
|
| Hospital Charge Code |
60628657
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$16.32 |
| Rate for Payer: Aetna Commercial |
$12.41
|
| Rate for Payer: Aetna Medicare Advantage |
$9.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.33
|
| Rate for Payer: Cigna Commercial |
$16.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.79
|
| Rate for Payer: Oxford Commercial |
$6.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.87
|
|
|
MORPHINE TAB SR 100MG
|
Facility
|
IP
|
$32.65
|
|
| Hospital Charge Code |
60628657
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$4.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.90
|
|
|
MORPHINE URINE OPIATE CONFIRM
|
Facility
|
OP
|
$138.45
|
|
|
Service Code
|
HCPCS 80361
|
| Hospital Charge Code |
3009152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$52.61
|
| Rate for Payer: Aetna Medicare Advantage |
$41.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.30
|
| Rate for Payer: Cigna Commercial |
$69.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.53
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.67
|
|
|
MORPHINE URINE OPIATE CONFIRM
|
Facility
|
IP
|
$138.45
|
|
|
Service Code
|
HCPCS 80361
|
| Hospital Charge Code |
3009152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.77 |
| Max. Negotiated Rate |
$20.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.77
|
|
|
MORPHIX PROCEDURE PACK
|
Facility
|
IP
|
$750.00
|
|
| Hospital Charge Code |
270687493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
MORPHIX PROCEDURE PACK
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
270687493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$225.00
|
| Rate for Payer: Oxford Commercial |
$150.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$150.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.88
|
|
|
MORPHIX SUTURE ANCHOR
|
Facility
|
OP
|
$2,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.65 |
| Max. Negotiated Rate |
$1,237.50 |
| Rate for Payer: Aetna Commercial |
$940.50
|
| Rate for Payer: Aetna Medicare Advantage |
$742.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$631.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$631.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$631.12
|
| Rate for Payer: Cigna Commercial |
$1,237.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$598.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$544.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$371.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$65.59
|
|
|
MORPHIX SUTURE ANCHOR
|
Facility
|
IP
|
$2,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$371.25 |
| Max. Negotiated Rate |
$598.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$495.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$598.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$544.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$371.25
|
|
|
MORPHOMETRIC ANALYSIS IHC
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 88360
|
| Hospital Charge Code |
38474053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$730.60 |
| Rate for Payer: Aetna Commercial |
$550.53
|
| Rate for Payer: Aetna Medicare Advantage |
$655.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$730.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$730.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$202.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$730.60
|
| Rate for Payer: Cigna Commercial |
$405.73
|
| Rate for Payer: Cigna Medicare Advantage |
$202.40
|
| Rate for Payer: Clover Medicare Advantage |
$192.28
|
| Rate for Payer: EmblemHealth Commercial |
$607.20
|
| Rate for Payer: Humana Medicare Advantage |
$208.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$202.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.98
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
MORPHOMETRIC ANALYSIS IHC
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 88360
|
| Hospital Charge Code |
38474053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
MORPHOMETRIC IN-SITU
|
Facility
|
IP
|
$411.00
|
|
|
Service Code
|
HCPCS 88368
|
| Hospital Charge Code |
38474054
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$61.65 |
| Max. Negotiated Rate |
$61.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.65
|
|
|
MORPHOMETRIC IN-SITU
|
Facility
|
OP
|
$411.00
|
|
|
Service Code
|
HCPCS 88368
|
| Hospital Charge Code |
38474054
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$10.89 |
| Max. Negotiated Rate |
$1,537.15 |
| Rate for Payer: Aetna Commercial |
$1,158.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1,379.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,537.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,537.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$425.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,537.15
|
| Rate for Payer: Cigna Commercial |
$853.60
|
| Rate for Payer: Cigna Medicare Advantage |
$425.84
|
| Rate for Payer: Clover Medicare Advantage |
$404.55
|
| Rate for Payer: EmblemHealth Commercial |
$1,277.52
|
| Rate for Payer: Humana Medicare Advantage |
$438.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$425.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$123.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$120.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.89
|
|
|
MORRHUATE SOD 50MG/ML 30ML INJ
|
Facility
|
OP
|
$240.00
|
|
| Hospital Charge Code |
6006886
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.00
|
| Rate for Payer: Oxford Commercial |
$48.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$48.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.36
|
|
|
MORRHUATE SOD 50MG/ML 30ML INJ
|
Facility
|
IP
|
$240.00
|
|
| Hospital Charge Code |
6006886
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
MOTILITY STUDY***
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
HCPCS 91010
|
| Hospital Charge Code |
1001100
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$2,348.37 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,600.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,600.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,348.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,600.25
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$243.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.46
|
|
|
MOTILITY STUDY***
|
Facility
|
IP
|
$810.00
|
|
|
Service Code
|
HCPCS 91010
|
| Hospital Charge Code |
1001100
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$121.50 |
| Max. Negotiated Rate |
$121.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.50
|
|
|
MOT LACTATION SERVICES
|
Facility
|
IP
|
$2,700.00
|
|
| Hospital Charge Code |
93082050
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$405.00
|
|
|
MOT LACTATION SERVICES
|
Facility
|
OP
|
$2,700.00
|
|
| Hospital Charge Code |
93082050
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$65.07 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,026.00
|
| Rate for Payer: Aetna Medicare Advantage |
$810.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$688.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$688.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$688.50
|
| Rate for Payer: Cigna Commercial |
$1,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$810.00
|
| Rate for Payer: Oxford Commercial |
$686.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$405.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,202.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$71.55
|
|
|
MOTOR SPEECH CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GN
|
| Hospital Charge Code |
84201159
|
|
Hospital Revenue Code
|
449
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|