|
TUBING HIGH PRESS 72in HPF720E
|
Facility
|
OP
|
$30.90
|
|
| Hospital Charge Code |
270628012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$15.45 |
| Rate for Payer: Aetna Commercial |
$11.74
|
| Rate for Payer: Aetna Medicare Advantage |
$9.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.88
|
| Rate for Payer: Cigna Commercial |
$15.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.27
|
| Rate for Payer: Oxford Commercial |
$6.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.82
|
|
|
TUBING HIGH PRESSURE
|
Facility
|
OP
|
$205.65
|
|
| Hospital Charge Code |
270601453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.96 |
| Max. Negotiated Rate |
$102.83 |
| Rate for Payer: Aetna Commercial |
$78.15
|
| Rate for Payer: Aetna Medicare Advantage |
$61.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.44
|
| Rate for Payer: Cigna Commercial |
$102.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.70
|
| Rate for Payer: Oxford Commercial |
$41.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$41.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.45
|
|
|
TUBING HIGH PRESSURE
|
Facility
|
IP
|
$205.65
|
|
| Hospital Charge Code |
270601453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.85 |
| Max. Negotiated Rate |
$30.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
|
|
TUBING HIGH PRESSURE 100
|
Facility
|
IP
|
$40.50
|
|
| Hospital Charge Code |
270667655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$6.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.08
|
|
|
TUBING HIGH PRESSURE 100
|
Facility
|
OP
|
$40.50
|
|
| Hospital Charge Code |
270667655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna Commercial |
$15.39
|
| Rate for Payer: Aetna Medicare Advantage |
$12.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.33
|
| Rate for Payer: Cigna Commercial |
$20.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.15
|
| Rate for Payer: Oxford Commercial |
$8.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.07
|
|
|
TUBING HIGH PRESSURE 120 PSI
|
Facility
|
OP
|
$687.50
|
|
| Hospital Charge Code |
270663793
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$343.75 |
| Rate for Payer: Aetna Commercial |
$261.25
|
| Rate for Payer: Aetna Medicare Advantage |
$206.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$175.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$175.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$175.31
|
| Rate for Payer: Cigna Commercial |
$343.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$206.25
|
| Rate for Payer: Oxford Commercial |
$137.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.22
|
|
|
TUBING HIGH PRESSURE 120 PSI
|
Facility
|
IP
|
$687.50
|
|
| Hospital Charge Code |
270663793
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$103.12 |
| Max. Negotiated Rate |
$103.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.12
|
|
|
TUBING HIGH PRESSURE 20
|
Facility
|
OP
|
$357.50
|
|
| Hospital Charge Code |
270658345
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$178.75 |
| Rate for Payer: Aetna Commercial |
$135.85
|
| Rate for Payer: Aetna Medicare Advantage |
$107.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.16
|
| Rate for Payer: Cigna Commercial |
$178.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$107.25
|
| Rate for Payer: Oxford Commercial |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$71.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.47
|
|
|
TUBING HIGH PRESSURE 20
|
Facility
|
IP
|
$357.50
|
|
| Hospital Charge Code |
270658345
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$53.62 |
| Max. Negotiated Rate |
$53.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
|
|
TUBING HIGH PRESSURE HPF480E
|
Facility
|
IP
|
$43.25
|
|
| Hospital Charge Code |
270623570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$6.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.49
|
|
|
TUBING HIGH PRESSURE HPF480E
|
Facility
|
OP
|
$43.25
|
|
| Hospital Charge Code |
270623570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$21.62 |
| Rate for Payer: Aetna Commercial |
$16.43
|
| Rate for Payer: Aetna Medicare Advantage |
$12.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.03
|
| Rate for Payer: Cigna Commercial |
$21.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.97
|
| Rate for Payer: Oxford Commercial |
$8.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.15
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
OP
|
$16.40
|
|
| Hospital Charge Code |
270658323N
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$8.20 |
| Rate for Payer: Aetna Commercial |
$6.23
|
| Rate for Payer: Aetna Medicare Advantage |
$4.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.18
|
| Rate for Payer: Cigna Commercial |
$8.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.92
|
| Rate for Payer: Oxford Commercial |
$3.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.43
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
IP
|
$16.40
|
|
| Hospital Charge Code |
270658323N
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$2.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.46
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
IP
|
$13.75
|
|
| Hospital Charge Code |
270658323
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$2.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
IP
|
$13.75
|
|
| Hospital Charge Code |
270658323S
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$2.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
OP
|
$13.75
|
|
| Hospital Charge Code |
270658323S
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: Aetna Commercial |
$5.22
|
| Rate for Payer: Aetna Medicare Advantage |
$4.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.51
|
| Rate for Payer: Cigna Commercial |
$6.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$2.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
OP
|
$13.75
|
|
| Hospital Charge Code |
270658323
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: Aetna Commercial |
$5.22
|
| Rate for Payer: Aetna Medicare Advantage |
$4.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.51
|
| Rate for Payer: Cigna Commercial |
$6.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$2.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
TUBING HME FLEX 1590
|
Facility
|
OP
|
$10.50
|
|
| Hospital Charge Code |
270633721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Aetna Commercial |
$3.99
|
| Rate for Payer: Aetna Medicare Advantage |
$3.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.68
|
| Rate for Payer: Cigna Commercial |
$5.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Oxford Commercial |
$2.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.28
|
|
|
TUBING HME FLEX 1590
|
Facility
|
IP
|
$10.50
|
|
| Hospital Charge Code |
270633721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$1.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.57
|
|
|
TUBING HORIZON NXT IV PUMP 610
|
Facility
|
OP
|
$346.45
|
|
| Hospital Charge Code |
270605409
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$173.22 |
| Rate for Payer: Aetna Commercial |
$131.65
|
| Rate for Payer: Aetna Medicare Advantage |
$103.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$88.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$88.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$88.34
|
| Rate for Payer: Cigna Commercial |
$173.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.94
|
| Rate for Payer: Oxford Commercial |
$69.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$69.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.18
|
|
|
TUBING HORIZON NXT IV PUMP 610
|
Facility
|
IP
|
$346.45
|
|
| Hospital Charge Code |
270605409
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$51.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.97
|
|
|
TUBING HUDSON CORRUGATED
|
Facility
|
IP
|
$24.85
|
|
| Hospital Charge Code |
270061436
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$3.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.73
|
|
|
TUBING HUDSON CORRUGATED
|
Facility
|
OP
|
$24.85
|
|
| Hospital Charge Code |
270061436
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$12.43 |
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna Medicare Advantage |
$7.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.34
|
| Rate for Payer: Cigna Commercial |
$12.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.46
|
| Rate for Payer: Oxford Commercial |
$4.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.66
|
|
|
TUBING HUDSON CORRUGATED *****
|
Facility
|
OP
|
$34.00
|
|
| Hospital Charge Code |
1601137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.67
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.20
|
| Rate for Payer: Oxford Commercial |
$6.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.90
|
|
|
TUBING HUDSON CORRUGATED *****
|
Facility
|
IP
|
$34.00
|
|
| Hospital Charge Code |
1601137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$5.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.10
|
|
