|
GUIDE WIRE .025x150 ANGLED
|
Facility
|
OP
|
$209.00
|
|
| Hospital Charge Code |
270650900
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$104.50 |
| Rate for Payer: Aetna Commercial |
$62.70
|
| Rate for Payer: Aetna Medicare Advantage |
$62.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.30
|
| Rate for Payer: Cigna Commercial |
$104.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.17
|
| Rate for Payer: Oxford Commercial |
$104.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$104.50
|
|
|
GUIDEWIRE 028x125 230281
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
270631392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
|
|
GUIDEWIRE 028x125 230281
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
270631392
|
|
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
|
|
|
GUIDEWIRE .035 145cm
|
Facility
|
OP
|
$51.50
|
|
| Hospital Charge Code |
270626851
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$25.75 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna Medicare Advantage |
$15.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.13
|
| Rate for Payer: Cigna Commercial |
$25.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.70
|
| Rate for Payer: Oxford Commercial |
$25.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.75
|
|
|
GUIDEWIRE .035 145cm
|
Facility
|
IP
|
$51.50
|
|
| Hospital Charge Code |
270626851
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$7.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.72
|
|
|
GUIDEWIRE 0.35 260cm
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270645893
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
GUIDEWIRE 0.35 260cm
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270645893
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
GUIDEWIRE.035 260cm 3mm EXCH J
|
Facility
|
IP
|
$318.75
|
|
| Hospital Charge Code |
270616019
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.81
|
|
|
GUIDEWIRE.035 260cm 3mm EXCH J
|
Facility
|
OP
|
$318.75
|
|
| Hospital Charge Code |
270616019
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$41.44 |
| Max. Negotiated Rate |
$159.38 |
| Rate for Payer: Aetna Commercial |
$95.62
|
| Rate for Payer: Aetna Medicare Advantage |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.28
|
| Rate for Payer: Cigna Commercial |
$159.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.44
|
| Rate for Payer: Oxford Commercial |
$159.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.38
|
|
|
GUIDEWIRE .035 260CM ANGL
|
Facility
|
OP
|
$1,612.50
|
|
| Hospital Charge Code |
270642562
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.88 |
| Max. Negotiated Rate |
$806.25 |
| Rate for Payer: Aetna Commercial |
$483.75
|
| Rate for Payer: Aetna Medicare Advantage |
$483.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$411.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$411.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$411.19
|
| Rate for Payer: Cigna Commercial |
$806.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$390.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.88
|
|
|
GUIDEWIRE .035 260CM ANGL
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642562S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
GUIDEWIRE .035 260CM ANGL
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642562S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
GUIDEWIRE .035 260CM ANGL
|
Facility
|
IP
|
$1,612.50
|
|
| Hospital Charge Code |
270642562
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.88 |
| Max. Negotiated Rate |
$390.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$322.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$390.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.88
|
|
|
GUIDEWIRE .035 DUAL FLEX STR
|
Facility
|
IP
|
$374.66
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270625399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.20 |
| Max. Negotiated Rate |
$90.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.20
|
|
|
GUIDEWIRE .035 DUAL FLEX STR
|
Facility
|
OP
|
$374.66
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270625399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.20 |
| Max. Negotiated Rate |
$187.33 |
| Rate for Payer: Aetna Commercial |
$112.40
|
| Rate for Payer: Aetna Medicare Advantage |
$112.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.54
|
| Rate for Payer: Cigna Commercial |
$187.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.20
|
|
|
GUIDEWIRE .035 J TIP FIXED
|
Facility
|
OP
|
$55.75
|
|
| Hospital Charge Code |
270657662
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$27.88 |
| Rate for Payer: Aetna Commercial |
$16.73
|
| Rate for Payer: Aetna Medicare Advantage |
$16.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.22
|
| Rate for Payer: Cigna Commercial |
$27.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.36
|
|
|
GUIDEWIRE .035 J TIP FIXED
|
Facility
|
IP
|
$55.75
|
|
| Hospital Charge Code |
270657662
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$13.49 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.36
|
|
|
GUIDEWIRE .035 MM
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270682455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$47.50 |
| Rate for Payer: Aetna Commercial |
$28.50
|
| Rate for Payer: Aetna Medicare Advantage |
$28.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.23
|
| Rate for Payer: Cigna Commercial |
$47.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.25
|
|
|
GUIDEWIRE .035 MM
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270682455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$22.99 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.25
|
|
|
GUIDEWIRE .035x150CM
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270676578N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
GUIDEWIRE .035x150CM
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270676578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.50
|
| Rate for Payer: Cigna Commercial |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
GUIDEWIRE .035x150CM
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270676578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
GUIDEWIRE .035x150CM
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270676578N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.50
|
| Rate for Payer: Cigna Commercial |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
GUIDEWIRE .038 150cm STRAIGHT
|
Facility
|
IP
|
$212.50
|
|
| Hospital Charge Code |
270605414
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.88 |
| Max. Negotiated Rate |
$31.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.88
|
|
|
GUIDEWIRE .038 150cm STRAIGHT
|
Facility
|
OP
|
$212.50
|
|
| Hospital Charge Code |
270605414
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.62 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare Advantage |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.19
|
| Rate for Payer: Cigna Commercial |
$106.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.62
|
| Rate for Payer: Oxford Commercial |
$106.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$106.25
|
|