|
CURETTE VAC BUSSE ******
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
1607324
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.06
|
| Rate for Payer: Cigna Commercial |
$6.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.80
|
|
|
CURETTE VAC BUSSE ALL SIZE****
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
1607316
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$2.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.80
|
|
|
CURETTE VAC BUSSE ALL SIZE****
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
1607316
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.06
|
| Rate for Payer: Cigna Commercial |
$6.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.80
|
|
|
CURETTE VACUUM 10MM CRVD
|
Facility
|
OP
|
$23.92
|
|
| Hospital Charge Code |
270600253
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$11.96 |
| Rate for Payer: Aetna Commercial |
$7.18
|
| Rate for Payer: Aetna Medicare Advantage |
$7.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.10
|
| Rate for Payer: Cigna Commercial |
$11.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.11
|
| Rate for Payer: Oxford Commercial |
$11.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.96
|
|
|
CURETTE VACUUM 10MM CRVD
|
Facility
|
IP
|
$23.92
|
|
| Hospital Charge Code |
270600253
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$3.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.59
|
|
|
CURETTE VACUUM 10mm STR
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270600255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.30
|
| Rate for Payer: Oxford Commercial |
$12.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.70
|
|
|
CURETTE VACUUM 10mm STR
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270600255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 11MM STR
|
Facility
|
OP
|
$14.80
|
|
| Hospital Charge Code |
270677262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$7.40 |
| Rate for Payer: Aetna Commercial |
$4.44
|
| Rate for Payer: Aetna Medicare Advantage |
$4.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.77
|
| Rate for Payer: Cigna Commercial |
$7.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.92
|
| Rate for Payer: Oxford Commercial |
$7.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.40
|
|
|
CURETTE VACUUM 11MM STR
|
Facility
|
IP
|
$14.80
|
|
| Hospital Charge Code |
270677262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.22 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.22
|
|
|
CURETTE VACUUM 12mm CRVD
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270613956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.30
|
| Rate for Payer: Oxford Commercial |
$12.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.70
|
|
|
CURETTE VACUUM 12mm CRVD
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270613956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 12mm STR
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270600256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.30
|
| Rate for Payer: Oxford Commercial |
$12.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.70
|
|
|
CURETTE VACUUM 12mm STR
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270600256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 7MM RIGID STR
|
Facility
|
IP
|
$126.00
|
|
| Hospital Charge Code |
270656354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
|
|
CURETTE VACUUM 7MM RIGID STR
|
Facility
|
OP
|
$126.00
|
|
| Hospital Charge Code |
270656354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$37.80
|
| Rate for Payer: Aetna Medicare Advantage |
$37.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.13
|
| Rate for Payer: Cigna Commercial |
$63.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.38
|
| Rate for Payer: Oxford Commercial |
$63.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.00
|
|
|
CURETTE VACUUM 8mm CRVD
|
Facility
|
OP
|
$9.44
|
|
| Hospital Charge Code |
270600252
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$2.83
|
| Rate for Payer: Aetna Medicare Advantage |
$2.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.41
|
| Rate for Payer: Cigna Commercial |
$4.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.23
|
| Rate for Payer: Oxford Commercial |
$4.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.72
|
|
|
CURETTE VACUUM 8mm CRVD
|
Facility
|
IP
|
$9.44
|
|
| Hospital Charge Code |
270600252
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$1.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
|
|
CURETTE VACUUM 8MM RIGID STR
|
Facility
|
OP
|
$9.44
|
|
| Hospital Charge Code |
270600254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$2.83
|
| Rate for Payer: Aetna Medicare Advantage |
$2.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.41
|
| Rate for Payer: Cigna Commercial |
$4.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.23
|
| Rate for Payer: Oxford Commercial |
$4.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.72
|
|
|
CURETTE VACUUM 8MM RIGID STR
|
Facility
|
IP
|
$9.44
|
|
| Hospital Charge Code |
270600254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$1.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
|
|
CURETTE VACUUM 9MM RIGID STR
|
Facility
|
IP
|
$14.75
|
|
| Hospital Charge Code |
270656355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.21
|
|
|
CURETTE VACUUM 9MM RIGID STR
|
Facility
|
OP
|
$14.75
|
|
| Hospital Charge Code |
270656355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$7.38 |
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: Aetna Medicare Advantage |
$4.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.76
|
| Rate for Payer: Cigna Commercial |
$7.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.92
|
| Rate for Payer: Oxford Commercial |
$7.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.38
|
|
|
Curosurf 120mg/1.5ml
|
Facility
|
OP
|
$4,815.63
|
|
|
Service Code
|
NDC 10122051001
|
| Hospital Charge Code |
6063943282
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$626.03 |
| Max. Negotiated Rate |
$2,407.82 |
| Rate for Payer: Aetna Commercial |
$1,444.69
|
| Rate for Payer: Aetna Medicare Advantage |
$1,444.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,227.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,227.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,227.99
|
| Rate for Payer: Cigna Commercial |
$2,407.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$626.03
|
| Rate for Payer: Oxford Commercial |
$2,407.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$722.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,407.82
|
|
|
Curosurf 120mg/1.5ml
|
Facility
|
IP
|
$4,815.63
|
|
|
Service Code
|
NDC 10122051001
|
| Hospital Charge Code |
6063943282
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$722.34 |
| Max. Negotiated Rate |
$722.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$722.34
|
|
|
CURRENT EVENTS GROUP PSYCHOTPY
|
Facility
|
OP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246300
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$241.93 |
| Rate for Payer: Aetna Commercial |
$240.24
|
| Rate for Payer: Aetna Medicare Advantage |
$240.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.20
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$104.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
|
|
CURRENT EVENTS GROUP PSYCHOTPY
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246300
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|