|
CAUTERY HOOK 5mm LPSL5
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
270628276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
CAUTERY HOOK 5mm LPSL5
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
270628276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.75 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna Commercial |
$52.50
|
| Rate for Payer: Aetna Medicare Advantage |
$52.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.62
|
| Rate for Payer: Cigna Commercial |
$87.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.75
|
| Rate for Payer: Oxford Commercial |
$87.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$87.50
|
|
|
CAUTERY HOT TEMP FINE TIP
|
Facility
|
IP
|
$43.95
|
|
| Hospital Charge Code |
270651811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$6.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.59
|
|
|
CAUTERY HOT TEMP FINE TIP
|
Facility
|
OP
|
$43.95
|
|
| Hospital Charge Code |
270651811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.71 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: Aetna Commercial |
$13.19
|
| Rate for Payer: Aetna Medicare Advantage |
$13.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.21
|
| Rate for Payer: Cigna Commercial |
$21.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.71
|
| Rate for Payer: Oxford Commercial |
$21.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.98
|
|
|
CAUTERY OPHTHALMIC
|
Facility
|
OP
|
$33.48
|
|
| Hospital Charge Code |
270649365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$10.04
|
| Rate for Payer: Aetna Medicare Advantage |
$10.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.54
|
| Rate for Payer: Cigna Commercial |
$16.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.35
|
| Rate for Payer: Oxford Commercial |
$16.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$16.74
|
|
|
CAUTERY OPHTHALMIC
|
Facility
|
IP
|
$33.48
|
|
| Hospital Charge Code |
270649365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.02
|
|
|
CAUTERY OPHTH STER 84-41000
|
Facility
|
IP
|
$49.65
|
|
| Hospital Charge Code |
270617094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$7.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.45
|
|
|
CAUTERY OPHTH STER 84-41000
|
Facility
|
OP
|
$49.65
|
|
| Hospital Charge Code |
270617094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$24.82 |
| Rate for Payer: Aetna Commercial |
$14.89
|
| Rate for Payer: Aetna Medicare Advantage |
$14.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.66
|
| Rate for Payer: Cigna Commercial |
$24.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.45
|
| Rate for Payer: Oxford Commercial |
$24.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.82
|
|
|
CAUTERY OPHTH XOMED 0006821
|
Facility
|
IP
|
$63.25
|
|
| Hospital Charge Code |
270060635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.49 |
| Max. Negotiated Rate |
$9.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.49
|
|
|
CAUTERY OPHTH XOMED 0006821
|
Facility
|
OP
|
$63.25
|
|
| Hospital Charge Code |
270060635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.22 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$18.98
|
| Rate for Payer: Aetna Medicare Advantage |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.13
|
| Rate for Payer: Cigna Commercial |
$31.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.22
|
| Rate for Payer: Oxford Commercial |
$31.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.62
|
|
|
CAUTERY PEDIATRIC PAD E7510-25
|
Facility
|
IP
|
$44.85
|
|
| Hospital Charge Code |
270611088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$6.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
|
|
CAUTERY PEDIATRIC PAD E7510-25
|
Facility
|
OP
|
$44.85
|
|
| Hospital Charge Code |
270611088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$22.43 |
| Rate for Payer: Aetna Commercial |
$13.46
|
| Rate for Payer: Aetna Medicare Advantage |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.44
|
| Rate for Payer: Cigna Commercial |
$22.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.83
|
| Rate for Payer: Oxford Commercial |
$22.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.43
|
|
|
CAUTERY VALLEY LAB ******
|
Facility
|
IP
|
$187.00
|
|
| Hospital Charge Code |
1800259
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.05 |
| Max. Negotiated Rate |
$28.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.05
|
|
|
CAUTERY VALLEY LAB ******
|
Facility
|
OP
|
$187.00
|
|
| Hospital Charge Code |
1800259
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.31 |
| Max. Negotiated Rate |
$93.50 |
| Rate for Payer: Aetna Commercial |
$56.10
|
| Rate for Payer: Aetna Medicare Advantage |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.69
|
| Rate for Payer: Cigna Commercial |
$93.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.31
|
| Rate for Payer: Oxford Commercial |
$93.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$93.50
|
|
|
CAVILON BARRIER CREAM 1.3% 1OZ
|
Facility
|
OP
|
$12.86
|
|
|
Service Code
|
NDC 17518003003
|
| Hospital Charge Code |
606390442
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$6.43 |
| Rate for Payer: Aetna Commercial |
$3.86
|
| Rate for Payer: Aetna Medicare Advantage |
$3.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.28
|
| Rate for Payer: Cigna Commercial |
$6.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.67
|
| Rate for Payer: Oxford Commercial |
$6.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.43
|
|
|
CAVILON BARRIER CREAM 1.3% 1OZ
|
Facility
|
IP
|
$12.86
|
|
|
Service Code
|
NDC 17518003003
|
| Hospital Charge Code |
606390442
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.93 |
| Max. Negotiated Rate |
$1.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.93
|
|
|
CAVUX FAC FIX SY 4MM
|
Facility
|
OP
|
$14,000.00
|
|
| Hospital Charge Code |
270702429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$7,000.00 |
| Rate for Payer: Aetna Commercial |
$4,200.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,570.00
|
| Rate for Payer: Cigna Commercial |
$7,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,388.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,100.00
|
|
|
CAVUX FAC FIX SY 4MM
|
Facility
|
IP
|
$14,000.00
|
|
| Hospital Charge Code |
270702429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$3,388.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,388.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,100.00
|
|
|
CBC (NO DIFF)
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 85027
|
| Hospital Charge Code |
3005403
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$20.96
|
| Rate for Payer: Aetna Medicare Advantage |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.71
|
| Rate for Payer: Cigna Commercial |
$6.47
|
| Rate for Payer: Cigna Medicare Advantage |
$3.23
|
| Rate for Payer: Clover Medicare Advantage |
$6.15
|
| Rate for Payer: EmblemHealth Commercial |
$19.41
|
| Rate for Payer: Humana Medicare Advantage |
$6.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.79
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.47
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.47
|
|
|
CBC (NO DIFF)
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 85027
|
| Hospital Charge Code |
3005403
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
CBC NO DIFF
|
Facility
|
OP
|
$46.35
|
|
|
Service Code
|
HCPCS 85027
|
| Hospital Charge Code |
3005394
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$20.96
|
| Rate for Payer: Aetna Medicare Advantage |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.71
|
| Rate for Payer: Cigna Commercial |
$6.47
|
| Rate for Payer: Cigna Medicare Advantage |
$3.23
|
| Rate for Payer: Clover Medicare Advantage |
$6.15
|
| Rate for Payer: EmblemHealth Commercial |
$19.41
|
| Rate for Payer: Humana Medicare Advantage |
$6.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.03
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.47
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.47
|
|
|
CBC NO DIFF
|
Facility
|
IP
|
$46.35
|
|
|
Service Code
|
HCPCS 85027
|
| Hospital Charge Code |
3005394
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.95
|
|
|
CBC ONCOLOGY CLINIC
|
Facility
|
IP
|
$531.04
|
|
|
Service Code
|
HCPCS 85025
|
| Hospital Charge Code |
3030871
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$79.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.66
|
|
|
CBC ONCOLOGY CLINIC
|
Facility
|
OP
|
$531.04
|
|
|
Service Code
|
HCPCS 85025
|
| Hospital Charge Code |
3030871
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$25.17
|
| Rate for Payer: Aetna Medicare Advantage |
$7.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.47
|
| Rate for Payer: Cigna Commercial |
$7.77
|
| Rate for Payer: Cigna Medicare Advantage |
$3.88
|
| Rate for Payer: Clover Medicare Advantage |
$7.38
|
| Rate for Payer: EmblemHealth Commercial |
$23.31
|
| Rate for Payer: Humana Medicare Advantage |
$8.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.04
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.77
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$8.24
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.77
|
|
|
CBC PATHOLOGIST REVIEW
|
Facility
|
OP
|
$133.65
|
|
|
Service Code
|
HCPCS 85060
|
| Hospital Charge Code |
3007978
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare Advantage |
$40.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$20.60
|
| Rate for Payer: Cigna Medicare Advantage |
$10.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.37
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|