|
DISPOSABLE LIGHT CABLE
|
Facility
|
OP
|
$2,500.00
|
|
| Hospital Charge Code |
270694229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$325.00 |
| Max. Negotiated Rate |
$1,250.00 |
| Rate for Payer: Aetna Commercial |
$750.00
|
| Rate for Payer: Aetna Medicare Advantage |
$750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$637.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$637.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$637.50
|
| Rate for Payer: Cigna Commercial |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$325.00
|
| Rate for Payer: Oxford Commercial |
$1,250.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$375.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,250.00
|
|
|
DISPOSABLE LIGHT CABLE
|
Facility
|
IP
|
$2,500.00
|
|
| Hospital Charge Code |
270694229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$375.00 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$375.00
|
|
|
DISPOSABLE NTCURVED RF CANNULA
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
270322295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
|
|
DISPOSABLE NTCURVED RF CANNULA
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
270322295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$15.00
|
| Rate for Payer: Aetna Medicare Advantage |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.75
|
| Rate for Payer: Cigna Commercial |
$25.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.50
|
| Rate for Payer: Oxford Commercial |
$25.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.00
|
|
|
DISPOSABLE NT RF GROUND PADS
|
Facility
|
OP
|
$28.00
|
|
| Hospital Charge Code |
270322296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$8.40
|
| Rate for Payer: Aetna Medicare Advantage |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.14
|
| Rate for Payer: Cigna Commercial |
$14.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.64
|
| Rate for Payer: Oxford Commercial |
$14.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.00
|
|
|
DISPOSABLE NT RF GROUND PADS
|
Facility
|
IP
|
$28.00
|
|
| Hospital Charge Code |
270322296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
|
|
DISPOSABLE PERFORATOR
|
Facility
|
OP
|
$665.00
|
|
| Hospital Charge Code |
270335101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.45 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$199.50
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.45
|
| Rate for Payer: Oxford Commercial |
$332.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$332.50
|
|
|
DISPOSABLE PERFORATOR
|
Facility
|
IP
|
$665.00
|
|
| Hospital Charge Code |
270335101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
DISPOSABLE SCALP CLIP APPLIER
|
Facility
|
IP
|
$72.00
|
|
| Hospital Charge Code |
270335576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
DISPOSABLE SCALP CLIP APPLIER
|
Facility
|
OP
|
$72.00
|
|
| Hospital Charge Code |
270335576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$21.60
|
| Rate for Payer: Aetna Medicare Advantage |
$21.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.36
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.36
|
| Rate for Payer: Oxford Commercial |
$36.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.00
|
|
|
DISPOSABLESKIT,FOR3MMSUTURETAC
|
Facility
|
IP
|
$2,420.00
|
|
| Hospital Charge Code |
270663911
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.00
|
|
|
DISPOSABLESKIT,FOR3MMSUTURETAC
|
Facility
|
OP
|
$2,420.00
|
|
| Hospital Charge Code |
270663911
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$314.60 |
| Max. Negotiated Rate |
$1,210.00 |
| Rate for Payer: Aetna Commercial |
$726.00
|
| Rate for Payer: Aetna Medicare Advantage |
$726.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$617.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$617.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$617.10
|
| Rate for Payer: Cigna Commercial |
$1,210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$314.60
|
| Rate for Payer: Oxford Commercial |
$1,210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,210.00
|
|
|
DISPOSAL CHEMICAL WASTE
|
Facility
|
IP
|
$2,810.00
|
|
| Hospital Charge Code |
270659112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$421.50 |
| Max. Negotiated Rate |
$680.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$562.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$680.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$421.50
|
|
|
DISPOSAL CHEMICAL WASTE
|
Facility
|
OP
|
$2,810.00
|
|
| Hospital Charge Code |
270659112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$421.50 |
| Max. Negotiated Rate |
$1,405.00 |
| Rate for Payer: Aetna Commercial |
$843.00
|
| Rate for Payer: Aetna Medicare Advantage |
$843.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$716.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$716.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$562.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$716.55
|
| Rate for Payer: Cigna Commercial |
$1,405.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$680.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$421.50
|
|
|
DISPOS KIT KNEE FIBERTAK
|
Facility
|
IP
|
$12,611.75
|
|
| Hospital Charge Code |
270703163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,891.76 |
| Max. Negotiated Rate |
$1,891.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,891.76
|
|
|
DISPOS KIT KNEE FIBERTAK
|
Facility
|
OP
|
$12,611.75
|
|
| Hospital Charge Code |
270703163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,639.53 |
| Max. Negotiated Rate |
$6,305.88 |
| Rate for Payer: Aetna Commercial |
$3,783.53
|
| Rate for Payer: Aetna Medicare Advantage |
$3,783.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,216.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,216.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,216.00
|
| Rate for Payer: Cigna Commercial |
$6,305.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,639.53
|
| Rate for Payer: Oxford Commercial |
$6,305.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,891.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,305.88
|
|
|
DISPO. VEIN STRIPPERS
|
Facility
|
IP
|
$98.00
|
|
| Hospital Charge Code |
270339008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
DISPO. VEIN STRIPPERS
|
Facility
|
OP
|
$98.00
|
|
| Hospital Charge Code |
270339008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Aetna Commercial |
$29.40
|
| Rate for Payer: Aetna Medicare Advantage |
$29.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.99
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.74
|
| Rate for Payer: Oxford Commercial |
$49.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.00
|
|
|
DISP PEEP VALVE 5-20 CM 22 MM
|
Facility
|
OP
|
$15.55
|
|
| Hospital Charge Code |
270689022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Aetna Commercial |
$4.67
|
| Rate for Payer: Aetna Medicare Advantage |
$4.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.97
|
| Rate for Payer: Cigna Commercial |
$7.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.02
|
| Rate for Payer: Oxford Commercial |
$7.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.78
|
|
|
DISP PEEP VALVE 5-20 CM 22 MM
|
Facility
|
IP
|
$15.55
|
|
| Hospital Charge Code |
270689022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$2.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.33
|
|
|
DISSECTING HOOK 5MM HDH05
|
Facility
|
OP
|
$975.35
|
|
| Hospital Charge Code |
270609764
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.80 |
| Max. Negotiated Rate |
$487.68 |
| Rate for Payer: Aetna Commercial |
$292.61
|
| Rate for Payer: Aetna Medicare Advantage |
$292.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.71
|
| Rate for Payer: Cigna Commercial |
$487.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.80
|
| Rate for Payer: Oxford Commercial |
$487.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$487.68
|
|
|
DISSECTING HOOK 5MM HDH05
|
Facility
|
IP
|
$975.35
|
|
| Hospital Charge Code |
270609764
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.30 |
| Max. Negotiated Rate |
$146.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.30
|
|
|
DISSECTING TOOL
|
Facility
|
OP
|
$764.75
|
|
| Hospital Charge Code |
270657887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.42 |
| Max. Negotiated Rate |
$382.38 |
| Rate for Payer: Aetna Commercial |
$229.43
|
| Rate for Payer: Aetna Medicare Advantage |
$229.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$195.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$195.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$195.01
|
| Rate for Payer: Cigna Commercial |
$382.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.42
|
| Rate for Payer: Oxford Commercial |
$382.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$382.38
|
|
|
DISSECTING TOOL
|
Facility
|
IP
|
$764.75
|
|
| Hospital Charge Code |
270657887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.71 |
| Max. Negotiated Rate |
$114.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.71
|
|
|
DISSECTING TOOL
|
Facility
|
IP
|
$636.50
|
|
| Hospital Charge Code |
270657897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$95.47 |
| Max. Negotiated Rate |
$95.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.47
|
|