|
TUBE ENDO CUFFED 4.0mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 4.0mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 4.5mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649282
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 4.5mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649282
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 5.0mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 5.0mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 5.5mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 5.5mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 6.0mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 6.0mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 6.5mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 6.5mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 7.0mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 7.0mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 7.5mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 7.5mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 8.0mm
|
Facility
|
IP
|
$11.18
|
|
| Hospital Charge Code |
270649292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$1.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.68
|
|
|
TUBE ENDO CUFFED 8.0mm
|
Facility
|
OP
|
$11.18
|
|
| Hospital Charge Code |
270649292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$5.59 |
| Rate for Payer: Aetna Commercial |
$4.25
|
| Rate for Payer: Aetna Medicare Advantage |
$3.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.85
|
| Rate for Payer: Cigna Commercial |
$5.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.35
|
| Rate for Payer: Oxford Commercial |
$2.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.24
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.30
|
|
|
TUBE ENDO CUFFED 8.5mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 8.5mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 9.0mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDO CUFFED 9.0mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 9.5mm
|
Facility
|
OP
|
$8.63
|
|
| Hospital Charge Code |
270649295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.20
|
| Rate for Payer: Cigna Commercial |
$4.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.59
|
| Rate for Payer: Oxford Commercial |
$1.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
TUBE ENDO CUFFED 9.5mm
|
Facility
|
IP
|
$8.63
|
|
| Hospital Charge Code |
270649295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.29
|
|
|
TUBE ENDOTRACH 2.0MM
|
Facility
|
IP
|
$13.65
|
|
| Hospital Charge Code |
270070110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
|