|
HEPARIN 10 UNITS/ML INJ
|
Facility
|
OP
|
$4.85
|
|
| Hospital Charge Code |
60628920
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$2.42 |
| Rate for Payer: Aetna Commercial |
$1.46
|
| Rate for Payer: Aetna Medicare Advantage |
$1.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.24
|
| Rate for Payer: Cigna Commercial |
$2.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.73
|
|
|
HEPARIN 25000/250ML/D5W
|
Facility
|
IP
|
$42.00
|
|
| Hospital Charge Code |
60634977
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$10.16 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.30
|
|
|
HEPARIN 25000/250ML/D5W
|
Facility
|
OP
|
$42.00
|
|
| Hospital Charge Code |
60634977
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: Aetna Medicare Advantage |
$12.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.71
|
| Rate for Payer: Cigna Commercial |
$21.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.30
|
|
|
HEPARIN 25000/500ML/D5W
|
Facility
|
IP
|
$36.00
|
|
| Hospital Charge Code |
60634978
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$8.71 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.40
|
|
|
HEPARIN 25000/500ML/D5W
|
Facility
|
OP
|
$36.00
|
|
| Hospital Charge Code |
60634978
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$10.80
|
| Rate for Payer: Aetna Medicare Advantage |
$10.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.18
|
| Rate for Payer: Cigna Commercial |
$18.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.40
|
|
|
HEPARIN 25000U/250ML BAGS
|
Facility
|
IP
|
$59.23
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
60635054
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.88 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.88
|
|
|
HEPARIN 25000U/250ML BAGS
|
Facility
|
OP
|
$59.23
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
60635054
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$17.77 |
| Rate for Payer: Aetna Commercial |
$17.77
|
| Rate for Payer: Aetna Medicare Advantage |
$17.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.10
|
| Rate for Payer: Cigna Commercial |
$0.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.88
|
|
|
HEPARIN 5000 UNITS/ML INJ
|
Facility
|
OP
|
$6.70
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
60627511
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$2.01 |
| Rate for Payer: Aetna Commercial |
$2.01
|
| Rate for Payer: Aetna Medicare Advantage |
$2.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.71
|
| Rate for Payer: Cigna Commercial |
$0.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
|
|
HEPARIN 5000 UNITS/ML INJ
|
Facility
|
IP
|
$6.70
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
60627511
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.62 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
|
|
Heparin, Anti-Xa
|
Facility
|
OP
|
$480.85
|
|
|
Service Code
|
HCPCS 85520
|
| Hospital Charge Code |
401085520
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$42.41
|
| Rate for Payer: Aetna Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.96
|
| Rate for Payer: Cigna Commercial |
$13.09
|
| Rate for Payer: Cigna Medicare Advantage |
$6.54
|
| Rate for Payer: Clover Medicare Advantage |
$12.44
|
| Rate for Payer: EmblemHealth Commercial |
$39.27
|
| Rate for Payer: Humana Medicare Advantage |
$13.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$62.51
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.09
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$13.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.09
|
|
|
Heparin, Anti-Xa
|
Facility
|
IP
|
$480.85
|
|
|
Service Code
|
HCPCS 85520
|
| Hospital Charge Code |
401085520
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$72.13 |
| Max. Negotiated Rate |
$72.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.13
|
|
|
HEPARIN ANTI-XA
|
Facility
|
IP
|
$65.45
|
|
|
Service Code
|
HCPCS 85520
|
| Hospital Charge Code |
38476001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.82
|
|
|
HEPARIN ANTI-XA
|
Facility
|
OP
|
$65.45
|
|
|
Service Code
|
HCPCS 85520
|
| Hospital Charge Code |
38476001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$42.41
|
| Rate for Payer: Aetna Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.96
|
| Rate for Payer: Cigna Commercial |
$13.09
|
| Rate for Payer: Cigna Medicare Advantage |
$6.54
|
| Rate for Payer: Clover Medicare Advantage |
$12.44
|
| Rate for Payer: EmblemHealth Commercial |
$39.27
|
| Rate for Payer: Humana Medicare Advantage |
$13.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.51
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.09
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$13.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.09
|
|
|
HEPARIN ASSAY
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
HCPCS 85520
|
| Hospital Charge Code |
38477112
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$45.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
HEPARIN ASSAY
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
HCPCS 85520
|
| Hospital Charge Code |
38477112
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$42.41
|
| Rate for Payer: Aetna Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.96
|
| Rate for Payer: Cigna Commercial |
$13.09
|
| Rate for Payer: Cigna Medicare Advantage |
$6.54
|
| Rate for Payer: Clover Medicare Advantage |
$12.44
|
| Rate for Payer: EmblemHealth Commercial |
$39.27
|
| Rate for Payer: Humana Medicare Advantage |
$13.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.65
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.09
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$13.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.09
|
|
|
HEPARIN BEEF 1000U/ML 10ML VL
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
6010169
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
HEPARIN BEEF 1000U/ML 10ML VL
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
6010169
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
HEPARIN BEEF INJ 10000U/10ML
|
Facility
|
IP
|
$12.20
|
|
| Hospital Charge Code |
60629164
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.83
|
|
|
HEPARIN BEEF INJ 10000U/10ML
|
Facility
|
OP
|
$12.20
|
|
| Hospital Charge Code |
60629164
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$6.10 |
| Rate for Payer: Aetna Commercial |
$3.66
|
| Rate for Payer: Aetna Medicare Advantage |
$3.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.11
|
| Rate for Payer: Cigna Commercial |
$6.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.59
|
| Rate for Payer: Oxford Commercial |
$6.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.10
|
|
|
HEPARIN FLS 100U/1 ML INJ 3 ML
|
Facility
|
OP
|
$38.12
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
6012595
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$11.44 |
| Rate for Payer: Aetna Commercial |
$11.44
|
| Rate for Payer: Aetna Medicare Advantage |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.72
|
| Rate for Payer: Cigna Commercial |
$0.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.72
|
|
|
HEPARIN FLS 100U/1 ML INJ 3 ML
|
Facility
|
IP
|
$38.12
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
6012595
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$9.23 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.72
|
|
|
HEPARIN FLUSHING NEEDLE
|
Facility
|
IP
|
$95.00
|
|
| Hospital Charge Code |
270667265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.25
|
|
|
HEPARIN FLUSHING NEEDLE
|
Facility
|
OP
|
$95.00
|
|
| Hospital Charge Code |
270667265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.35 |
| 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) PPO |
$24.23
|
| Rate for Payer: Cigna Commercial |
$47.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.35
|
| Rate for Payer: Oxford Commercial |
$47.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.50
|
|
|
HEPARIN FLUSH TUBEX
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
6012603
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$0.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.58
|
|
|
HEPARIN FLUSH TUBEX
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
6012603
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.93 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: Aetna Medicare Advantage |
$1.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.98
|
| Rate for Payer: Cigna Commercial |
$1.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.50
|
| Rate for Payer: Oxford Commercial |
$1.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.93
|
|