|
ANGIOTENSIN II
|
Facility
|
IP
|
$145.34
|
|
|
Service Code
|
HCPCS 82163
|
| Hospital Charge Code |
38477167
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$21.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.80
|
|
|
ANGIOTENSIN II
|
Facility
|
OP
|
$145.34
|
|
|
Service Code
|
HCPCS 82163
|
| Hospital Charge Code |
38477167
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$66.48
|
| Rate for Payer: Aetna Medicare Advantage |
$20.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$43.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.19
|
| Rate for Payer: Cigna Commercial |
$20.52
|
| Rate for Payer: Cigna Medicare Advantage |
$10.26
|
| Rate for Payer: Clover Medicare Advantage |
$19.49
|
| Rate for Payer: EmblemHealth Commercial |
$61.56
|
| Rate for Payer: Humana Medicare Advantage |
$21.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.89
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.52
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$21.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.52
|
|
|
ANGIO THRU EX CATH F/U EMB INF
|
Facility
|
OP
|
$1,008.00
|
|
|
Service Code
|
HCPCS 75898
|
| Hospital Charge Code |
5100432
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.04 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$302.40
|
| Rate for Payer: Aetna Medicare Advantage |
$302.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$257.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$257.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$205.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$257.04
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.04
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
ANGIO THRU EX CATH F/U EMB INF
|
Facility
|
OP
|
$1,008.00
|
|
|
Service Code
|
HCPCS 75898
|
| Hospital Charge Code |
74110047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.04 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$302.40
|
| Rate for Payer: Aetna Medicare Advantage |
$302.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$257.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$257.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$205.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$257.04
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$131.04
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
ANGIO THRU EX CATH F/U EMB INF
|
Facility
|
IP
|
$1,008.00
|
|
|
Service Code
|
HCPCS 75898
|
| Hospital Charge Code |
5100432
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
|
|
ANGIO THRU EX CATH F/U EMB INF
|
Facility
|
IP
|
$1,008.00
|
|
|
Service Code
|
HCPCS 75898
|
| Hospital Charge Code |
74110047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
|
|
ANGIO THRU EXISTING CATH
|
Facility
|
IP
|
$971.00
|
|
| Hospital Charge Code |
2009105
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$145.65 |
| Max. Negotiated Rate |
$145.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.65
|
|
|
ANGIO THRU EXISTING CATH
|
Facility
|
OP
|
$971.00
|
|
| Hospital Charge Code |
2009105
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.23 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$291.30
|
| Rate for Payer: Aetna Medicare Advantage |
$291.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$247.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$247.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$247.60
|
| Rate for Payer: Cigna Commercial |
$485.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$126.23
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
ANGIO THRU EXISTING CATH FUP**
|
Facility
|
IP
|
$901.00
|
|
|
Service Code
|
HCPCS 75898
|
| Hospital Charge Code |
5100553
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$135.15 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.15
|
|
|
ANGIO THRU EXISTING CATH FUP**
|
Facility
|
OP
|
$901.00
|
|
|
Service Code
|
HCPCS 75898
|
| Hospital Charge Code |
5100553
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$117.13 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$270.30
|
| Rate for Payer: Aetna Medicare Advantage |
$270.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$229.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$229.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$205.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$229.75
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.13
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
ANGIO TRAY
|
Facility
|
OP
|
$67.00
|
|
| Hospital Charge Code |
4800955
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$33.50 |
| Rate for Payer: Aetna Commercial |
$20.10
|
| Rate for Payer: Aetna Medicare Advantage |
$20.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.09
|
| Rate for Payer: Cigna Commercial |
$33.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.71
|
| Rate for Payer: Oxford Commercial |
$33.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.50
|
|
|
ANGIO TRAY
|
Facility
|
IP
|
$67.00
|
|
| Hospital Charge Code |
4800955
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$10.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.05
|
|
|
ANGLED ATTACHMENT
|
Facility
|
IP
|
$4,986.60
|
|
| Hospital Charge Code |
270657060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$747.99 |
| Max. Negotiated Rate |
$1,206.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$997.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,206.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$747.99
|
|
|
ANGLED ATTACHMENT
|
Facility
|
OP
|
$4,986.60
|
|
| Hospital Charge Code |
270657060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$747.99 |
| Max. Negotiated Rate |
$2,493.30 |
| Rate for Payer: Aetna Commercial |
$1,495.98
|
| Rate for Payer: Aetna Medicare Advantage |
$1,495.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,271.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,271.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$997.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,271.58
|
| Rate for Payer: Cigna Commercial |
$2,493.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,206.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$747.99
|
|
|
ANGLED LIGHTS MODULE
|
Facility
|
IP
|
$3,260.00
|
|
| Hospital Charge Code |
270657292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$489.00 |
| Max. Negotiated Rate |
$788.92 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$652.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$788.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$489.00
|
|
|
ANGLED LIGHTS MODULE
|
Facility
|
OP
|
$3,260.00
|
|
| Hospital Charge Code |
270657292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$489.00 |
| Max. Negotiated Rate |
$1,630.00 |
| Rate for Payer: Aetna Commercial |
$978.00
|
| Rate for Payer: Aetna Medicare Advantage |
$978.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$831.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$831.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$652.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$831.30
|
| Rate for Payer: Cigna Commercial |
$1,630.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$788.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$489.00
|
|
|
ANGLED PHALANX SMALL
|
Facility
|
OP
|
$5,390.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$808.50 |
| Max. Negotiated Rate |
$2,695.00 |
| Rate for Payer: Aetna Commercial |
$1,617.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,617.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,374.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,374.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,078.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,374.45
|
| Rate for Payer: Cigna Commercial |
$2,695.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,304.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$808.50
|
|
|
ANGLED PHALANX SMALL
|
Facility
|
IP
|
$5,390.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$808.50 |
| Max. Negotiated Rate |
$1,304.38 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,078.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,304.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$808.50
|
|
|
ANGLE GLIDEWIRE .035 260
|
Facility
|
OP
|
$230.41
|
|
| Hospital Charge Code |
2709000699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.95 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna Commercial |
$69.12
|
| Rate for Payer: Aetna Medicare Advantage |
$69.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.75
|
| Rate for Payer: Cigna Commercial |
$115.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.95
|
| Rate for Payer: Oxford Commercial |
$115.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.20
|
|
|
ANGLE GLIDEWIRE .035 260
|
Facility
|
IP
|
$230.41
|
|
| Hospital Charge Code |
2709000699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.56 |
| Max. Negotiated Rate |
$34.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.56
|
|
|
ANGLE SCREW SELF DRILL 3.8X16
|
Facility
|
OP
|
$2,500.00
|
|
| Hospital Charge Code |
270703196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$375.00 |
| 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) NJ Health |
$500.00
|
| 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 |
$605.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$375.00
|
|
|
ANGLE SCREW SELF DRILL 3.8X16
|
Facility
|
IP
|
$2,500.00
|
|
| Hospital Charge Code |
270703196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$375.00 |
| Max. Negotiated Rate |
$605.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$605.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$375.00
|
|
|
ANIPULATE HIP JNT W ANESTH
|
Facility
|
OP
|
$6,527.12
|
|
|
Service Code
|
HCPCS 27275
|
| Hospital Charge Code |
16000330
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$848.53 |
| Max. Negotiated Rate |
$3,829.26 |
| Rate for Payer: Aetna Commercial |
$1,958.14
|
| Rate for Payer: Aetna Medicare Advantage |
$1,958.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,664.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,664.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,664.42
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$848.53
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$979.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
ANIPULATE HIP JNT W ANESTH
|
Facility
|
IP
|
$6,527.12
|
|
|
Service Code
|
HCPCS 27275
|
| Hospital Charge Code |
16000330
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$979.07 |
| Max. Negotiated Rate |
$979.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$979.07
|
|
|
ANISTREPLASE INJ 30 UNIT
|
Facility
|
OP
|
$13,138.60
|
|
| Hospital Charge Code |
6008510
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,970.79 |
| Max. Negotiated Rate |
$6,569.30 |
| Rate for Payer: Aetna Commercial |
$3,941.58
|
| Rate for Payer: Aetna Medicare Advantage |
$3,941.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,350.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,350.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,350.34
|
| Rate for Payer: Cigna Commercial |
$6,569.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,179.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,970.79
|
|