|
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
|
|
|
BATTERY AA ALKALINE
|
Facility
|
IP
|
$0.88
|
|
| Hospital Charge Code |
270300285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.13
|
|
|
BATTERY AA ALKALINE
|
Facility
|
OP
|
$0.88
|
|
| Hospital Charge Code |
270300285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.44 |
| Rate for Payer: Aetna Commercial |
$0.33
|
| Rate for Payer: Aetna Medicare Advantage |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.22
|
| Rate for Payer: Cigna Commercial |
$0.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.26
|
| 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
|
|
|
BATTERY C PROCELL
|
Facility
|
IP
|
$2.16
|
|
| Hospital Charge Code |
270300295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.32
|
|
|
BATTERY C PROCELL
|
Facility
|
OP
|
$2.16
|
|
| Hospital Charge Code |
270300295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$1.08 |
| Rate for Payer: Aetna Commercial |
$0.82
|
| Rate for Payer: Aetna Medicare Advantage |
$0.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.55
|
| Rate for Payer: Cigna Commercial |
$1.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.65
|
| Rate for Payer: Oxford Commercial |
$0.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.06
|
|
|
BATTERY PACK POWER DEVICE SYST
|
Facility
|
IP
|
$2,941.15
|
|
| Hospital Charge Code |
270656381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$441.17 |
| Max. Negotiated Rate |
$441.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$441.17
|
|
|
BATTERY PACK POWER DEVICE SYST
|
Facility
|
OP
|
$2,941.15
|
|
| Hospital Charge Code |
270656381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.88 |
| Max. Negotiated Rate |
$1,470.58 |
| Rate for Payer: Aetna Commercial |
$1,117.64
|
| Rate for Payer: Aetna Medicare Advantage |
$882.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$749.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$749.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$749.99
|
| Rate for Payer: Cigna Commercial |
$1,470.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$882.35
|
| Rate for Payer: Oxford Commercial |
$588.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$441.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$588.23
|
| Rate for Payer: UnitedHealthcare Community & State |
$70.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$77.94
|
|
|
BATTERY PRO 2 DRILL
|
Facility
|
OP
|
$2,525.00
|
|
| Hospital Charge Code |
270690137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.85 |
| Max. Negotiated Rate |
$1,262.50 |
| Rate for Payer: Aetna Commercial |
$959.50
|
| Rate for Payer: Aetna Medicare Advantage |
$757.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$643.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$643.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$643.88
|
| Rate for Payer: Cigna Commercial |
$1,262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$757.50
|
| Rate for Payer: Oxford Commercial |
$505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$378.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$505.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$60.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$66.91
|
|
|
BATTERY PRO 2 DRILL
|
Facility
|
IP
|
$2,525.00
|
|
| Hospital Charge Code |
270690137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.75 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$378.75
|
|
|
BATTERY RECHARGABLE SEALED LE
|
Facility
|
OP
|
$3,168.75
|
|
| Hospital Charge Code |
270656383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.37 |
| Max. Negotiated Rate |
$1,584.38 |
| Rate for Payer: Aetna Commercial |
$1,204.12
|
| Rate for Payer: Aetna Medicare Advantage |
$950.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$808.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$808.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$808.03
|
| Rate for Payer: Cigna Commercial |
$1,584.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$950.62
|
| Rate for Payer: Oxford Commercial |
$633.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$475.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$633.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$76.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$83.97
|
|
|
BATTERY RECHARGABLE SEALED LE
|
Facility
|
IP
|
$3,168.75
|
|
| Hospital Charge Code |
270656383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$475.31 |
| Max. Negotiated Rate |
$475.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$475.31
|
|
|
BATTERY SMART
|
Facility
|
IP
|
$511.00
|
|
| Hospital Charge Code |
270665805
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.65 |
| Max. Negotiated Rate |
$76.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$76.65
|
|
|
BATTERY SMART
|
Facility
|
OP
|
$511.00
|
|
| Hospital Charge Code |
270665805
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$255.50 |
| Rate for Payer: Aetna Commercial |
$194.18
|
| Rate for Payer: Aetna Medicare Advantage |
$153.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$130.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$130.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$130.31
|
| Rate for Payer: Cigna Commercial |
$255.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$153.30
|
| Rate for Payer: Oxford Commercial |
$102.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$76.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$102.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.54
|
|
|
BATTERY SORIN REPLY DR
|
Facility
|
OP
|
$19,142.50
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
270672799
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$461.33 |
| Max. Negotiated Rate |
$9,571.25 |
| Rate for Payer: Aetna Commercial |
$7,274.15
|
| Rate for Payer: Aetna Medicare Advantage |
$5,742.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,881.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,881.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,828.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,881.34
|
| Rate for Payer: Cigna Commercial |
$9,571.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,632.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,211.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,871.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$461.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$507.28
|
|
|
BATTERY SORIN REPLY DR
|
Facility
|
IP
|
$19,142.50
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
270672799
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,871.38 |
| Max. Negotiated Rate |
$4,632.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,828.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,632.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,211.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,871.38
|
|
|
BATTERY XL SMART (3PK)
|
Facility
|
OP
|
$2,317.75
|
|
| Hospital Charge Code |
270665804
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$1,158.88 |
| Rate for Payer: Aetna Commercial |
$880.75
|
| Rate for Payer: Aetna Medicare Advantage |
$695.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$591.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$591.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$591.03
|
| Rate for Payer: Cigna Commercial |
$1,158.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.33
|
| Rate for Payer: Oxford Commercial |
$463.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$347.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$463.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$55.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$61.42
|
|
|
BATTERY XL SMART (3PK)
|
Facility
|
IP
|
$2,317.75
|
|
| Hospital Charge Code |
270665804
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$347.66 |
| Max. Negotiated Rate |
$347.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$347.66
|
|
|
BAYER CHILDREN'S ASPIRIN
|
Facility
|
IP
|
$1.00
|
|
| Hospital Charge Code |
60632533
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.15
|
|
|
BAYER CHILDREN'S ASPIRIN
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
60632533
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: Aetna Commercial |
$0.38
|
| Rate for Payer: Aetna Medicare Advantage |
$0.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.26
|
| Rate for Payer: Cigna Commercial |
$0.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.30
|
| Rate for Payer: Oxford Commercial |
$0.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.03
|
|
|
BB PHYSICIAN SERVICE/CONSULT
|
Facility
|
OP
|
$396.85
|
|
|
Service Code
|
HCPCS 86077
|
| Hospital Charge Code |
3100195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$124.03 |
| Rate for Payer: Aetna Commercial |
$93.46
|
| Rate for Payer: Aetna Medicare Advantage |
$111.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$124.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$124.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$34.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$124.03
|
| Rate for Payer: Cigna Commercial |
$68.87
|
| Rate for Payer: Cigna Medicare Advantage |
$34.36
|
| Rate for Payer: Clover Medicare Advantage |
$32.64
|
| Rate for Payer: EmblemHealth Commercial |
$103.08
|
| Rate for Payer: Humana Medicare Advantage |
$35.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$34.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.06
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$34.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$34.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.52
|
|
|
BB PHYSICIAN SERVICE/CONSULT
|
Facility
|
IP
|
$396.85
|
|
|
Service Code
|
HCPCS 86077
|
| Hospital Charge Code |
3100195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.53 |
| Max. Negotiated Rate |
$59.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.53
|
|
|
BB TAK
|
Facility
|
OP
|
$250.00
|
|
| Hospital Charge Code |
270652914
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$95.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.00
|
| Rate for Payer: Oxford Commercial |
$50.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.62
|
|
|
BB TAK
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270656495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
BB TAK
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270656495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.50
|
| Rate for Payer: Oxford Commercial |
$85.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.26
|
|
|
BB TAK
|
Facility
|
IP
|
$250.00
|
|
| Hospital Charge Code |
270652914
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|