|
CEFUROXINE NA VL 750MG
|
Facility
|
OP
|
$37.80
|
|
| Hospital Charge Code |
6006902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna Commercial |
$11.34
|
| Rate for Payer: Aetna Medicare Advantage |
$11.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.64
|
| Rate for Payer: Cigna Commercial |
$18.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.91
|
| Rate for Payer: Oxford Commercial |
$18.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.90
|
|
|
CEFUROXINE NA VL 750MG
|
Facility
|
IP
|
$37.80
|
|
| Hospital Charge Code |
6006902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$5.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.67
|
|
|
CEFUROXINE NA VL 750MG
|
Facility
|
IP
|
$109.45
|
|
| Hospital Charge Code |
6006944
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.42
|
|
|
CEFUROXINE NA VL 750MG
|
Facility
|
OP
|
$109.45
|
|
| Hospital Charge Code |
6006944
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$54.73 |
| Rate for Payer: Aetna Commercial |
$32.84
|
| Rate for Payer: Aetna Medicare Advantage |
$32.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.91
|
| Rate for Payer: Cigna Commercial |
$54.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.23
|
| Rate for Payer: Oxford Commercial |
$54.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$54.73
|
|
|
CELEBREX 100 MG CAP
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60635243
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
CELEBREX 100 MG CAP
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60635243
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.91
|
| Rate for Payer: Oxford Commercial |
$3.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.50
|
|
|
CELEBREX 100 MG U/D CAP
|
Facility
|
IP
|
$37.65
|
|
|
Service Code
|
NDC 58151008301
|
| Hospital Charge Code |
60635325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$5.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
|
|
CELEBREX 100 MG U/D CAP
|
Facility
|
OP
|
$37.65
|
|
|
Service Code
|
NDC 58151008301
|
| Hospital Charge Code |
60635325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Aetna Commercial |
$11.29
|
| Rate for Payer: Aetna Medicare Advantage |
$11.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.60
|
| Rate for Payer: Cigna Commercial |
$18.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.89
|
| Rate for Payer: Oxford Commercial |
$18.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.82
|
|
|
CELEBREX 200 MG CAP
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60635244
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.91
|
| Rate for Payer: Oxford Commercial |
$3.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.50
|
|
|
CELEBREX 200 MG CAP
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60635244
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
CELEBREX 200 MG U/D CAP
|
Facility
|
IP
|
$61.77
|
|
|
Service Code
|
NDC 58151008401
|
| Hospital Charge Code |
60635326
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.27
|
|
|
CELEBREX 200 MG U/D CAP
|
Facility
|
OP
|
$61.77
|
|
|
Service Code
|
NDC 58151008401
|
| Hospital Charge Code |
60635326
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$30.89 |
| Rate for Payer: Aetna Commercial |
$18.53
|
| Rate for Payer: Aetna Medicare Advantage |
$18.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.75
|
| Rate for Payer: Cigna Commercial |
$30.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.03
|
| Rate for Payer: Oxford Commercial |
$30.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.89
|
|
|
CELEBRITY ENDO CYTO BRUSH
|
Facility
|
OP
|
$56.00
|
|
| Hospital Charge Code |
270656979
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$28.00 |
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Medicare Advantage |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.28
|
| Rate for Payer: Cigna Commercial |
$28.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.28
|
| Rate for Payer: Oxford Commercial |
$28.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$28.00
|
|
|
CELEBRITY ENDO CYTO BRUSH
|
Facility
|
IP
|
$56.00
|
|
| Hospital Charge Code |
270656979
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
|
|
CELECOXIB 100 MG CAP
|
Facility
|
IP
|
$12.85
|
|
| Hospital Charge Code |
60628962
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$1.93 |
| Max. Negotiated Rate |
$1.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.93
|
|
|
CELECOXIB 100 MG CAP
|
Facility
|
OP
|
$12.85
|
|
| Hospital Charge Code |
60628962
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$6.42 |
| Rate for Payer: Aetna Commercial |
$3.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3.85
|
| 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 |
$6.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.67
|
| Rate for Payer: Oxford Commercial |
$6.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.42
|
|
|
CELECOXIB 200 MG CAP
|
Facility
|
IP
|
$22.15
|
|
| Hospital Charge Code |
60629245
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$3.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.32
|
|
|
CELECOXIB 200 MG CAP
|
Facility
|
OP
|
$22.15
|
|
| Hospital Charge Code |
60629245
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna Commercial |
$6.64
|
| Rate for Payer: Aetna Medicare Advantage |
$6.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.65
|
| Rate for Payer: Cigna Commercial |
$11.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.88
|
| Rate for Payer: Oxford Commercial |
$11.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.07
|
|
|
CELESTONE 0.6MG/TAB
|
Facility
|
IP
|
$6.00
|
|
| Hospital Charge Code |
60634356
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
CELESTONE 0.6MG/TAB
|
Facility
|
OP
|
$6.00
|
|
| Hospital Charge Code |
60634356
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.53
|
| Rate for Payer: Cigna Commercial |
$3.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.78
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
|
|
CELESTONE/0.6MG/TAB
|
Facility
|
IP
|
$6.00
|
|
| Hospital Charge Code |
60632663
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
CELESTONE/0.6MG/TAB
|
Facility
|
OP
|
$6.00
|
|
| Hospital Charge Code |
60632663
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.53
|
| Rate for Payer: Cigna Commercial |
$3.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.78
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
|
|
CELESTONE PHOSPHATE/3MG
|
Facility
|
OP
|
$80.00
|
|
| Hospital Charge Code |
60632664
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$24.00
|
| Rate for Payer: Aetna Medicare Advantage |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.40
|
| Rate for Payer: Cigna Commercial |
$40.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
|
|
CELESTONE PHOSPHATE/3MG
|
Facility
|
IP
|
$80.00
|
|
| Hospital Charge Code |
60632664
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$19.36 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
|
|
CELEXA 10MG TAB
|
Facility
|
OP
|
$3.00
|
|
| Hospital Charge Code |
60635428
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare Advantage |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.77
|
| Rate for Payer: Cigna Commercial |
$1.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.39
|
| Rate for Payer: Oxford Commercial |
$1.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.50
|
|