|
UNI DERM ******
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
8002081
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Aetna Commercial |
$8.74
|
| Rate for Payer: Aetna Medicare Advantage |
$6.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.87
|
| Rate for Payer: Cigna Commercial |
$11.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.90
|
| Rate for Payer: Oxford Commercial |
$4.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.61
|
|
|
UNI DERM ******
|
Facility
|
IP
|
$23.00
|
|
| Hospital Charge Code |
8002081
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.45 |
| Max. Negotiated Rate |
$3.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.45
|
|
|
UNIPAK SURGICAL SUPPLIES
|
Facility
|
IP
|
$680.00
|
|
| Hospital Charge Code |
270331454
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.00
|
|
|
UNIPAK SURGICAL SUPPLIES
|
Facility
|
OP
|
$680.00
|
|
| Hospital Charge Code |
270331454
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$340.00 |
| Rate for Payer: Aetna Commercial |
$258.40
|
| Rate for Payer: Aetna Medicare Advantage |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$173.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$173.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$173.40
|
| Rate for Payer: Cigna Commercial |
$340.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$204.00
|
| Rate for Payer: Oxford Commercial |
$136.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$136.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.02
|
|
|
UNIPEN/500MG/TAB
|
Facility
|
IP
|
$13.00
|
|
| Hospital Charge Code |
60634114
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.95
|
|
|
UNIPEN/500MG/TAB
|
Facility
|
OP
|
$13.00
|
|
| Hospital Charge Code |
60634114
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$4.94
|
| Rate for Payer: Aetna Medicare Advantage |
$3.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.31
|
| Rate for Payer: Cigna Commercial |
$6.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.90
|
| Rate for Payer: Oxford Commercial |
$2.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|
|
UNIPEN ADV/1GM/D5/100
|
Facility
|
OP
|
$16.00
|
|
| Hospital Charge Code |
60634946
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna Commercial |
$6.08
|
| Rate for Payer: Aetna Medicare Advantage |
$4.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.08
|
| Rate for Payer: Cigna Commercial |
$8.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.80
|
| Rate for Payer: Oxford Commercial |
$3.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
UNIPEN ADV/1GM/D5/100
|
Facility
|
IP
|
$16.00
|
|
| Hospital Charge Code |
60634946
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.40
|
|
|
UNIPEN ADV/1GM/NS/100
|
Facility
|
OP
|
$16.00
|
|
| Hospital Charge Code |
60634949
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna Commercial |
$6.08
|
| Rate for Payer: Aetna Medicare Advantage |
$4.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.08
|
| Rate for Payer: Cigna Commercial |
$8.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.80
|
| Rate for Payer: Oxford Commercial |
$3.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
UNIPEN ADV/1GM/NS/100
|
Facility
|
IP
|
$16.00
|
|
| Hospital Charge Code |
60634949
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.40
|
|
|
UNIPEN ADV/2GM/D5/250
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
60634947
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
|
|
UNIPEN ADV/2GM/D5/250
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
60634947
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$12.50 |
| Rate for Payer: Aetna Commercial |
$9.50
|
| Rate for Payer: Aetna Medicare Advantage |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.38
|
| Rate for Payer: Cigna Commercial |
$12.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.50
|
| Rate for Payer: Oxford Commercial |
$5.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.66
|
|
|
UNIPEN ADV/2GM/NS/250
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
60634950
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
|
|
UNIPEN ADV/2GM/NS/250
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
60634950
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$5.70
|
| Rate for Payer: Aetna Medicare Advantage |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.83
|
| Rate for Payer: Cigna Commercial |
$7.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.50
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.40
|
|
|
UNIPLATE 16 MM
|
Facility
|
IP
|
$5,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686054
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$843.75 |
| Max. Negotiated Rate |
$1,361.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,361.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,237.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$843.75
|
|
|
UNIPLATE 16 MM
|
Facility
|
OP
|
$5,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686054
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.56 |
| Max. Negotiated Rate |
$2,812.50 |
| Rate for Payer: Aetna Commercial |
$2,137.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,687.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,434.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,434.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,434.38
|
| Rate for Payer: Cigna Commercial |
$2,812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,361.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,237.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$843.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$135.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$149.06
|
|
|
UNI-PUNCH 3.0 BIOPSY 9033503
|
Facility
|
IP
|
$5.20
|
|
| Hospital Charge Code |
270636847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$0.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.78
|
|
|
UNI-PUNCH 3.0 BIOPSY 9033503
|
Facility
|
OP
|
$5.20
|
|
| Hospital Charge Code |
270636847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: Aetna Commercial |
$1.98
|
| Rate for Payer: Aetna Medicare Advantage |
$1.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.33
|
| Rate for Payer: Cigna Commercial |
$2.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.56
|
| Rate for Payer: Oxford Commercial |
$1.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.04
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.14
|
|
|
UNI SOLVE ********
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
8002693
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
|
|
UNI SOLVE ********
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
8002693
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$12.50 |
| Rate for Payer: Aetna Commercial |
$9.50
|
| Rate for Payer: Aetna Medicare Advantage |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.38
|
| Rate for Payer: Cigna Commercial |
$12.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.50
|
| Rate for Payer: Oxford Commercial |
$5.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.66
|
|
|
UNIT COLLECTION DISP
|
Facility
|
OP
|
$44.00
|
|
| Hospital Charge Code |
270600489
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$22.00 |
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: Aetna Medicare Advantage |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.22
|
| Rate for Payer: Cigna Commercial |
$22.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.20
|
| Rate for Payer: Oxford Commercial |
$8.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.17
|
|
|
UNIT COLLECTION DISP
|
Facility
|
IP
|
$44.00
|
|
| Hospital Charge Code |
270600489
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$6.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
|
|
UNIT PLURAL VAC/SUC DRNG
|
Facility
|
IP
|
$392.00
|
|
| Hospital Charge Code |
270608495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$58.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.80
|
|
|
UNIT PLURAL VAC/SUC DRNG
|
Facility
|
OP
|
$392.00
|
|
| Hospital Charge Code |
270608495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$196.00 |
| Rate for Payer: Aetna Commercial |
$148.96
|
| Rate for Payer: Aetna Medicare Advantage |
$117.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$99.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$99.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$99.96
|
| Rate for Payer: Cigna Commercial |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.60
|
| Rate for Payer: Oxford Commercial |
$78.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$78.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.39
|
|
|
UNIV. CEMENT DISP. INST-SZ SM
|
Facility
|
OP
|
$930.00
|
|
| Hospital Charge Code |
270656569
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna Commercial |
$353.40
|
| Rate for Payer: Aetna Medicare Advantage |
$279.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$237.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$237.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$186.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$237.15
|
| Rate for Payer: Cigna Commercial |
$465.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$225.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$204.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$139.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.64
|
|