|
ASSAY OF TOTAL ESTRADIOL
|
Facility
|
IP
|
$123.17
|
|
|
Service Code
|
HCPCS 82670
|
| Hospital Charge Code |
401182670
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.48 |
| Max. Negotiated Rate |
$18.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.48
|
|
|
ASSAY OF TOTAL ESTRADIOL
|
Facility
|
OP
|
$123.17
|
|
|
Service Code
|
HCPCS 82670
|
| Hospital Charge Code |
401182670
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.97 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$90.53
|
| Rate for Payer: Aetna Medicare Advantage |
$27.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$27.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.37
|
| Rate for Payer: Cigna Commercial |
$27.94
|
| Rate for Payer: Cigna Medicare Advantage |
$13.97
|
| Rate for Payer: Clover Medicare Advantage |
$26.54
|
| Rate for Payer: EmblemHealth Commercial |
$83.82
|
| Rate for Payer: Humana Medicare Advantage |
$28.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.01
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$27.94
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$29.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$27.94
|
|
|
ASSAY OF TROPONIN QUANT
|
Facility
|
IP
|
$650.82
|
|
|
Service Code
|
HCPCS 84484
|
| Hospital Charge Code |
402084484
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$97.62 |
| Max. Negotiated Rate |
$97.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.62
|
|
|
ASSAY OF TROPONIN QUANT
|
Facility
|
OP
|
$650.82
|
|
|
Service Code
|
HCPCS 84484
|
| Hospital Charge Code |
402084484
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.85 |
| Max. Negotiated Rate |
$97.62 |
| Rate for Payer: Aetna Commercial |
$40.40
|
| Rate for Payer: Aetna Medicare Advantage |
$12.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.69
|
| Rate for Payer: Cigna Commercial |
$12.47
|
| Rate for Payer: Cigna Medicare Advantage |
$12.47
|
| Rate for Payer: Clover Medicare Advantage |
$11.85
|
| Rate for Payer: EmblemHealth Commercial |
$37.41
|
| Rate for Payer: Humana Medicare Advantage |
$12.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.47
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$13.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.47
|
|
|
ASSAY OF URINE CREATININE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
401082570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ASSAY OF URINE CREATININE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
401082570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.78
|
| Rate for Payer: Aetna Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.98
|
| Rate for Payer: Cigna Commercial |
$5.18
|
| Rate for Payer: Cigna Medicare Advantage |
$2.59
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
|
|
ASSAY OF URINE CREATININE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
401082570B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.78
|
| Rate for Payer: Aetna Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.98
|
| Rate for Payer: Cigna Commercial |
$5.18
|
| Rate for Payer: Cigna Medicare Advantage |
$2.59
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
|
|
ASSAY OF URINE CREATININE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
401082570B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ASSAY PROTEIN URINE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
401084166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ASSAY PROTEIN URINE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
401084166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$57.77
|
| Rate for Payer: Aetna Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.33
|
| Rate for Payer: Cigna Commercial |
$17.83
|
| Rate for Payer: Cigna Medicare Advantage |
$8.91
|
| Rate for Payer: Clover Medicare Advantage |
$16.94
|
| Rate for Payer: EmblemHealth Commercial |
$53.49
|
| Rate for Payer: Humana Medicare Advantage |
$18.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.83
|
|
|
ASSEMBL DEXTRUS SEAL CAP HAPO2
|
Facility
|
OP
|
$2,366.25
|
|
| Hospital Charge Code |
270640477
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$307.61 |
| Max. Negotiated Rate |
$1,183.12 |
| Rate for Payer: Aetna Commercial |
$709.88
|
| Rate for Payer: Aetna Medicare Advantage |
$709.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$603.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$603.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$603.39
|
| Rate for Payer: Cigna Commercial |
$1,183.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$307.61
|
| Rate for Payer: Oxford Commercial |
$1,183.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$354.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,183.12
|
|
|
ASSEMBL DEXTRUS SEAL CAP HAPO2
|
Facility
|
IP
|
$2,366.25
|
|
| Hospital Charge Code |
270640477
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$354.94 |
| Max. Negotiated Rate |
$354.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$354.94
|
|
|
ASSEMBLY ANCHOR W/BOLT FA10485
|
Facility
|
OP
|
$1,711.25
|
|
| Hospital Charge Code |
270629411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.69 |
| Max. Negotiated Rate |
$855.62 |
| Rate for Payer: Aetna Commercial |
$513.38
|
| Rate for Payer: Aetna Medicare Advantage |
$513.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.37
|
| Rate for Payer: Cigna Commercial |
$855.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$414.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.69
|
|
|
ASSEMBLY ANCHOR W/BOLT FA10485
|
Facility
|
IP
|
$1,711.25
|
|
| Hospital Charge Code |
270629411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.69 |
| Max. Negotiated Rate |
$414.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$414.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.69
|
|
|
ASSEMBLY BMT KNOB PULLR 472015
|
Facility
|
IP
|
$973.65
|
|
| Hospital Charge Code |
270612167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.05 |
| Max. Negotiated Rate |
$235.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$194.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.05
|
|
|
ASSEMBLY BMT KNOB PULLR 472015
|
Facility
|
OP
|
$973.65
|
|
| Hospital Charge Code |
270612167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.05 |
| Max. Negotiated Rate |
$486.82 |
| Rate for Payer: Aetna Commercial |
$292.10
|
| Rate for Payer: Aetna Medicare Advantage |
$292.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$194.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.28
|
| Rate for Payer: Cigna Commercial |
$486.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.05
|
|
|
ASSEMBLY DPY ANCH W/BOLT 10485
|
Facility
|
IP
|
$2,740.85
|
|
| Hospital Charge Code |
270612437
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$411.13 |
| Max. Negotiated Rate |
$663.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$548.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$663.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$411.13
|
|
|
ASSEMBLY DPY ANCH W/BOLT 10485
|
Facility
|
OP
|
$2,740.85
|
|
| Hospital Charge Code |
270612437
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$411.13 |
| Max. Negotiated Rate |
$1,370.42 |
| Rate for Payer: Aetna Commercial |
$822.25
|
| Rate for Payer: Aetna Medicare Advantage |
$822.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$698.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$698.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$548.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$698.92
|
| Rate for Payer: Cigna Commercial |
$1,370.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$663.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$411.13
|
|
|
ASSEMBLY DPY DIST W/BOLT 10480
|
Facility
|
IP
|
$2,570.45
|
|
| Hospital Charge Code |
270612436
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$385.57 |
| Max. Negotiated Rate |
$622.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$514.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$622.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$385.57
|
|
|
ASSEMBLY DPY DIST W/BOLT 10480
|
Facility
|
OP
|
$2,570.45
|
|
| Hospital Charge Code |
270612436
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$385.57 |
| Max. Negotiated Rate |
$1,285.22 |
| Rate for Payer: Aetna Commercial |
$771.13
|
| Rate for Payer: Aetna Medicare Advantage |
$771.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$655.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$655.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$514.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$655.46
|
| Rate for Payer: Cigna Commercial |
$1,285.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$622.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$385.57
|
|
|
ASSEMBLY HUML 8.0 REG 3281051
|
Facility
|
OP
|
$12,439.75
|
|
| Hospital Charge Code |
270609044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,865.96 |
| Max. Negotiated Rate |
$6,219.88 |
| Rate for Payer: Aetna Commercial |
$3,731.93
|
| Rate for Payer: Aetna Medicare Advantage |
$3,731.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,172.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,172.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,487.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,172.14
|
| Rate for Payer: Cigna Commercial |
$6,219.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,010.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,865.96
|
|
|
ASSEMBLY HUML 8.0 REG 3281051
|
Facility
|
IP
|
$12,439.75
|
|
| Hospital Charge Code |
270609044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,865.96 |
| Max. Negotiated Rate |
$3,010.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,487.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,010.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,865.96
|
|
|
ASSEMBLY KIT
|
Facility
|
OP
|
$3,070.00
|
|
| Hospital Charge Code |
270687909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$399.10 |
| Max. Negotiated Rate |
$1,535.00 |
| Rate for Payer: Aetna Commercial |
$921.00
|
| Rate for Payer: Aetna Medicare Advantage |
$921.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$782.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$782.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$782.85
|
| Rate for Payer: Cigna Commercial |
$1,535.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$399.10
|
| Rate for Payer: Oxford Commercial |
$1,535.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$460.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,535.00
|
|
|
ASSEMBLY KIT
|
Facility
|
IP
|
$3,070.00
|
|
| Hospital Charge Code |
270687909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.50 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$460.50
|
|
|
ASSEMBLY TUBE 2130
|
Facility
|
IP
|
$39.75
|
|
| Hospital Charge Code |
270634686
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$5.96 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.96
|
|