|
CLEANER ELECTRO-SURGICAL TIP
|
Facility
|
IP
|
$3.05
|
|
| Hospital Charge Code |
270649369N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.46
|
|
|
CLEANER ELECTRO-SURGICAL TIP
|
Facility
|
OP
|
$3.05
|
|
| Hospital Charge Code |
270649369S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$1.52 |
| Rate for Payer: Aetna Commercial |
$0.92
|
| Rate for Payer: Aetna Medicare Advantage |
$0.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.78
|
| Rate for Payer: Cigna Commercial |
$1.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.40
|
| Rate for Payer: Oxford Commercial |
$1.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.52
|
|
|
CLEANER ELECTRO-SURGICAL TIP
|
Facility
|
IP
|
$3.05
|
|
| Hospital Charge Code |
270649369
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.46
|
|
|
CLEANER ELECTRO-SURGICAL TIP
|
Facility
|
OP
|
$3.05
|
|
| Hospital Charge Code |
270649369N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$1.52 |
| Rate for Payer: Aetna Commercial |
$0.92
|
| Rate for Payer: Aetna Medicare Advantage |
$0.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.78
|
| Rate for Payer: Cigna Commercial |
$1.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.40
|
| Rate for Payer: Oxford Commercial |
$1.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.52
|
|
|
CLEANERS ********
|
Facility
|
IP
|
$131.00
|
|
| Hospital Charge Code |
8000275
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.65
|
|
|
CLEANERS ********
|
Facility
|
OP
|
$131.00
|
|
| Hospital Charge Code |
8000275
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$65.50 |
| Rate for Payer: Aetna Commercial |
$39.30
|
| Rate for Payer: Aetna Medicare Advantage |
$39.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.41
|
| Rate for Payer: Cigna Commercial |
$65.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.03
|
| Rate for Payer: Oxford Commercial |
$65.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.50
|
|
|
CLEANERS CHIX TISSUES
|
Facility
|
IP
|
$23.30
|
|
| Hospital Charge Code |
270649370
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.50
|
|
|
CLEANERS CHIX TISSUES
|
Facility
|
OP
|
$23.30
|
|
| Hospital Charge Code |
270649370
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$11.65 |
| Rate for Payer: Aetna Commercial |
$6.99
|
| Rate for Payer: Aetna Medicare Advantage |
$6.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.94
|
| Rate for Payer: Cigna Commercial |
$11.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.03
|
| Rate for Payer: Oxford Commercial |
$11.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.65
|
|
|
CLEANER SKIN CAVILON 8OZ 3380
|
Facility
|
IP
|
$10.00
|
|
| Hospital Charge Code |
270641326W
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.50
|
|
|
CLEANER SKIN CAVILON 8OZ 3380
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
270641326W
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$5.00 |
| Rate for Payer: Aetna Commercial |
$3.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.55
|
| Rate for Payer: Cigna Commercial |
$5.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.30
|
| Rate for Payer: Oxford Commercial |
$5.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.00
|
|
|
CLEANER STAINLESS STEEL 18OZ
|
Facility
|
OP
|
$27.95
|
|
| Hospital Charge Code |
270665154
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$13.97 |
| Rate for Payer: Aetna Commercial |
$8.38
|
| Rate for Payer: Aetna Medicare Advantage |
$8.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.13
|
| Rate for Payer: Cigna Commercial |
$13.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.63
|
| Rate for Payer: Oxford Commercial |
$13.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.97
|
|
|
CLEANER STAINLESS STEEL 18OZ
|
Facility
|
IP
|
$27.95
|
|
| Hospital Charge Code |
270665154
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|
|
CLEANER TIP
|
Facility
|
IP
|
$1.65
|
|
| Hospital Charge Code |
270656276
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$0.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.25
|
|
|
CLEANER TIP
|
Facility
|
OP
|
$1.65
|
|
| Hospital Charge Code |
270656276
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Aetna Commercial |
$0.50
|
| Rate for Payer: Aetna Medicare Advantage |
$0.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.42
|
| Rate for Payer: Cigna Commercial |
$0.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.21
|
| Rate for Payer: Oxford Commercial |
$0.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.83
|
|
|
CLEANERXT THR SYSTEM 6Fx135cm
|
Facility
|
IP
|
$4,250.00
|
|
| Hospital Charge Code |
270678568N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$637.50 |
| Max. Negotiated Rate |
$637.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$637.50
|
|
|
CLEANERXT THR SYSTEM 6Fx135cm
|
Facility
|
OP
|
$4,250.00
|
|
| Hospital Charge Code |
270678568N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$552.50 |
| Max. Negotiated Rate |
$2,125.00 |
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,083.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,083.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,083.75
|
| Rate for Payer: Cigna Commercial |
$2,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$552.50
|
| Rate for Payer: Oxford Commercial |
$2,125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$637.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,125.00
|
|
|
CLEANERXT THR SYSTEM 6Fx135cm
|
Facility
|
OP
|
$4,250.00
|
|
| Hospital Charge Code |
270678568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$552.50 |
| Max. Negotiated Rate |
$2,125.00 |
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,083.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,083.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,083.75
|
| Rate for Payer: Cigna Commercial |
$2,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$552.50
|
| Rate for Payer: Oxford Commercial |
$2,125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$637.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,125.00
|
|
|
CLEANERXT THR SYSTEM 6Fx135cm
|
Facility
|
IP
|
$4,250.00
|
|
| Hospital Charge Code |
270678568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$637.50 |
| Max. Negotiated Rate |
$637.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$637.50
|
|
|
CLEANERXT THR SYSTEM 6Fx65cm
|
Facility
|
OP
|
$2,750.00
|
|
| Hospital Charge Code |
270678567N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.50 |
| Max. Negotiated Rate |
$1,375.00 |
| Rate for Payer: Aetna Commercial |
$825.00
|
| Rate for Payer: Aetna Medicare Advantage |
$825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$701.25
|
| Rate for Payer: Cigna Commercial |
$1,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$357.50
|
| Rate for Payer: Oxford Commercial |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,375.00
|
|
|
CLEANERXT THR SYSTEM 6Fx65cm
|
Facility
|
OP
|
$2,750.00
|
|
| Hospital Charge Code |
270678567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.50 |
| Max. Negotiated Rate |
$1,375.00 |
| Rate for Payer: Aetna Commercial |
$825.00
|
| Rate for Payer: Aetna Medicare Advantage |
$825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$701.25
|
| Rate for Payer: Cigna Commercial |
$1,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$357.50
|
| Rate for Payer: Oxford Commercial |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,375.00
|
|
|
CLEANERXT THR SYSTEM 6Fx65cm
|
Facility
|
IP
|
$2,750.00
|
|
| Hospital Charge Code |
270678567N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.50 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
|
|
CLEANERXT THR SYSTEM 6Fx65cm
|
Facility
|
IP
|
$2,750.00
|
|
| Hospital Charge Code |
270678567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.50 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
|
|
CLEANING ADAPTER
|
Facility
|
OP
|
$165.00
|
|
| Hospital Charge Code |
270665253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.45 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Medicare Advantage |
$49.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.08
|
| Rate for Payer: Cigna Commercial |
$82.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.45
|
| Rate for Payer: Oxford Commercial |
$82.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$82.50
|
|
|
CLEANING ADAPTER
|
Facility
|
IP
|
$165.00
|
|
| Hospital Charge Code |
270665253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.75 |
| Max. Negotiated Rate |
$24.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.75
|
|
|
CLEAN KIT D
|
Facility
|
OP
|
$939.20
|
|
| Hospital Charge Code |
270665979
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$122.10 |
| Max. Negotiated Rate |
$469.60 |
| Rate for Payer: Aetna Commercial |
$281.76
|
| Rate for Payer: Aetna Medicare Advantage |
$281.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$239.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$239.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$239.50
|
| Rate for Payer: Cigna Commercial |
$469.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$122.10
|
| Rate for Payer: Oxford Commercial |
$469.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$469.60
|
|