|
BASKETTRAPEZOID 1.5cmx.035
|
Facility
|
OP
|
$1,353.40
|
|
| Hospital Charge Code |
270672229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.62 |
| Max. Negotiated Rate |
$676.70 |
| Rate for Payer: Aetna Commercial |
$514.29
|
| Rate for Payer: Aetna Medicare Advantage |
$406.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$345.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$345.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$345.12
|
| Rate for Payer: Cigna Commercial |
$676.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$406.02
|
| Rate for Payer: Oxford Commercial |
$270.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$203.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$270.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.87
|
|
|
BASKETTRAPEZOID 1.5cmx.035
|
Facility
|
IP
|
$1,353.40
|
|
| Hospital Charge Code |
270672229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$203.01 |
| Max. Negotiated Rate |
$203.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$203.01
|
|
|
BASKET TRAPEZOID 2.0cmx.035
|
Facility
|
OP
|
$1,353.40
|
|
| Hospital Charge Code |
270627940
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.62 |
| Max. Negotiated Rate |
$676.70 |
| Rate for Payer: Aetna Commercial |
$514.29
|
| Rate for Payer: Aetna Medicare Advantage |
$406.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$345.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$345.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$345.12
|
| Rate for Payer: Cigna Commercial |
$676.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$406.02
|
| Rate for Payer: Oxford Commercial |
$270.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$203.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$270.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.87
|
|
|
BASKET TRAPEZOID 2.0cmx.035
|
Facility
|
IP
|
$1,353.40
|
|
| Hospital Charge Code |
270627940
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$203.01 |
| Max. Negotiated Rate |
$203.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$203.01
|
|
|
BASKET ZERO TIP 3.0FX120CM
|
Facility
|
IP
|
$1,878.95
|
|
| Hospital Charge Code |
270698291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$281.84 |
| Max. Negotiated Rate |
$281.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.84
|
|
|
BASKET ZERO TIP 3.0FX120CM
|
Facility
|
OP
|
$1,878.95
|
|
| Hospital Charge Code |
270698291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.28 |
| Max. Negotiated Rate |
$939.48 |
| Rate for Payer: Aetna Commercial |
$714.00
|
| Rate for Payer: Aetna Medicare Advantage |
$563.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$479.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$479.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$479.13
|
| Rate for Payer: Cigna Commercial |
$939.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$563.68
|
| Rate for Payer: Oxford Commercial |
$375.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$375.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.79
|
|
|
BASKET ZERO TIP 3.0X90CM
|
Facility
|
OP
|
$1,875.00
|
|
| Hospital Charge Code |
270698290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.19 |
| Max. Negotiated Rate |
$937.50 |
| Rate for Payer: Aetna Commercial |
$712.50
|
| Rate for Payer: Aetna Medicare Advantage |
$562.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$478.12
|
| Rate for Payer: Cigna Commercial |
$937.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$562.50
|
| Rate for Payer: Oxford Commercial |
$375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$375.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.69
|
|
|
BASKET ZERO TIP 3.0X90CM
|
Facility
|
IP
|
$1,875.00
|
|
| Hospital Charge Code |
270698290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$281.25 |
| Max. Negotiated Rate |
$281.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
|
|
BASKET ZEROTIP AIRWAY RET 12MM
|
Facility
|
IP
|
$1,305.15
|
|
| Hospital Charge Code |
270676470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$195.77 |
| Max. Negotiated Rate |
$195.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$195.77
|
|
|
BASKET ZEROTIP AIRWAY RET 12MM
|
Facility
|
OP
|
$1,305.15
|
|
| Hospital Charge Code |
270676470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.45 |
| Max. Negotiated Rate |
$652.58 |
| Rate for Payer: Aetna Commercial |
$495.96
|
| Rate for Payer: Aetna Medicare Advantage |
$391.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$332.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$332.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$332.81
|
| Rate for Payer: Cigna Commercial |
$652.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$391.55
|
| Rate for Payer: Oxford Commercial |
$261.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$195.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$261.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.59
|
|
|
BASKET ZEROTIP AIRWAY RET 16MM
|
Facility
|
IP
|
$1,305.15
|
|
| Hospital Charge Code |
270676471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$195.77 |
| Max. Negotiated Rate |
$195.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$195.77
|
|
|
BASKET ZEROTIP AIRWAY RET 16MM
|
Facility
|
OP
|
$1,305.15
|
|
| Hospital Charge Code |
270676471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.45 |
| Max. Negotiated Rate |
$652.58 |
| Rate for Payer: Aetna Commercial |
$495.96
|
| Rate for Payer: Aetna Medicare Advantage |
$391.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$332.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$332.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$332.81
|
| Rate for Payer: Cigna Commercial |
$652.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$391.55
|
| Rate for Payer: Oxford Commercial |
$261.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$195.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$261.03
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.59
|
|
|
BASKET ZERO TIP NIT 1.9 x120CM
|
Facility
|
IP
|
$1,743.00
|
|
| Hospital Charge Code |
270684767
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.45 |
| Max. Negotiated Rate |
$261.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$261.45
|
|
|
BASKET ZERO TIP NIT 1.9 x120CM
|
Facility
|
OP
|
$1,743.00
|
|
| Hospital Charge Code |
270684767
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.01 |
| Max. Negotiated Rate |
$871.50 |
| Rate for Payer: Aetna Commercial |
$662.34
|
| Rate for Payer: Aetna Medicare Advantage |
$522.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$444.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$444.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$444.46
|
| Rate for Payer: Cigna Commercial |
$871.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$522.90
|
| Rate for Payer: Oxford Commercial |
$348.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$261.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$348.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$42.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.19
|
|
|
BATH BABY
|
Facility
|
OP
|
$5.65
|
|
| Hospital Charge Code |
270130020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.15
|
| Rate for Payer: Aetna Medicare Advantage |
$1.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.44
|
| Rate for Payer: Cigna Commercial |
$2.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.70
|
| Rate for Payer: Oxford Commercial |
$1.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.15
|
|
|
BATH BABY
|
Facility
|
IP
|
$5.65
|
|
| Hospital Charge Code |
270130020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
|
|
BATHMAT
|
Facility
|
OP
|
$2.45
|
|
| Hospital Charge Code |
270300280
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Aetna Commercial |
$0.93
|
| Rate for Payer: Aetna Medicare Advantage |
$0.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.62
|
| Rate for Payer: Cigna Commercial |
$1.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.74
|
| Rate for Payer: Oxford Commercial |
$0.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.49
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.06
|
|
|
BATHMAT
|
Facility
|
IP
|
$2.45
|
|
| Hospital Charge Code |
270300280
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.37
|
|
|
BATTERIES IQ
|
Facility
|
OP
|
$620.00
|
|
| Hospital Charge Code |
270662169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Aetna Commercial |
$235.60
|
| Rate for Payer: Aetna Medicare Advantage |
$186.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$158.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$158.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$158.10
|
| Rate for Payer: Cigna Commercial |
$310.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$186.00
|
| Rate for Payer: Oxford Commercial |
$124.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.43
|
|
|
BATTERIES IQ
|
Facility
|
IP
|
$620.00
|
|
| Hospital Charge Code |
270662169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.00 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.00
|
|
|
BATTERY 309/393 SILVER
|
Facility
|
OP
|
$9.20
|
|
| Hospital Charge Code |
270664124
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$4.60 |
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.35
|
| Rate for Payer: Cigna Commercial |
$4.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.76
|
| Rate for Payer: Oxford Commercial |
$1.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.84
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.24
|
|
|
BATTERY 309/393 SILVER
|
Facility
|
IP
|
$9.20
|
|
| Hospital Charge Code |
270664124
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$1.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.38
|
|
|
BATTERY 9 VOLT PROCELL
|
Facility
|
OP
|
$3.40
|
|
| Hospital Charge Code |
270300320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$1.70 |
| Rate for Payer: Aetna Commercial |
$1.29
|
| Rate for Payer: Aetna Medicare Advantage |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.87
|
| Rate for Payer: Cigna Commercial |
$1.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.02
|
| Rate for Payer: Oxford Commercial |
$0.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.09
|
|
|
BATTERY 9 VOLT PROCELL
|
Facility
|
IP
|
$3.40
|
|
| Hospital Charge Code |
270300320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$0.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.51
|
|
|
BATTERY AAA ALKALINE
|
Facility
|
OP
|
$0.89
|
|
| Hospital Charge Code |
270300290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.45 |
| Rate for Payer: Aetna Commercial |
$0.34
|
| Rate for Payer: Aetna Medicare Advantage |
$0.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.23
|
| Rate for Payer: Cigna Commercial |
$0.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.27
|
| Rate for Payer: Oxford Commercial |
$0.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.02
|
|