|
NATALIZUMAB 300MG VIAL
|
Facility
|
OP
|
$24,723.00
|
|
|
Service Code
|
HCPCS J2323
|
| Hospital Charge Code |
60630029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,708.45 |
| Max. Negotiated Rate |
$7,416.90 |
| Rate for Payer: Aetna Commercial |
$7,416.90
|
| Rate for Payer: Aetna Medicare Advantage |
$7,416.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,304.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,304.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,304.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,982.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,708.45
|
|
|
NATEGLINIDE 60 MG TAB
|
Facility
|
OP
|
$20.90
|
|
|
Service Code
|
NDC 78035105
|
| Hospital Charge Code |
60629187
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$10.45 |
| Rate for Payer: Aetna Commercial |
$6.27
|
| Rate for Payer: Aetna Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.33
|
| Rate for Payer: Cigna Commercial |
$10.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.72
|
| Rate for Payer: Oxford Commercial |
$10.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.45
|
|
|
NATEGLINIDE 60 MG TAB
|
Facility
|
IP
|
$20.90
|
|
|
Service Code
|
NDC 78035105
|
| Hospital Charge Code |
60629187
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$3.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.13
|
|
|
NAT KILLER CELLS,TOTAL COUNT
|
Facility
|
OP
|
$267.15
|
|
|
Service Code
|
HCPCS 86357
|
| Hospital Charge Code |
38477201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$138.24 |
| Rate for Payer: Aetna Commercial |
$122.25
|
| Rate for Payer: Aetna Medicare Advantage |
$37.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$37.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$78.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.24
|
| Rate for Payer: Cigna Commercial |
$37.73
|
| Rate for Payer: Cigna Medicare Advantage |
$18.86
|
| Rate for Payer: Clover Medicare Advantage |
$35.84
|
| Rate for Payer: EmblemHealth Commercial |
$113.19
|
| Rate for Payer: Humana Medicare Advantage |
$38.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.73
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$37.73
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$39.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$37.73
|
|
|
NAT KILLER CELLS,TOTAL COUNT
|
Facility
|
IP
|
$267.15
|
|
|
Service Code
|
HCPCS 86357
|
| Hospital Charge Code |
38477201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.07 |
| Max. Negotiated Rate |
$40.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.07
|
|
|
NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$340.75
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
3032050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$143.85 |
| Rate for Payer: Aetna Commercial |
$127.20
|
| Rate for Payer: Aetna Medicare Advantage |
$39.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$143.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$143.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$39.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$143.85
|
| Rate for Payer: Cigna Commercial |
$39.26
|
| Rate for Payer: Cigna Medicare Advantage |
$19.63
|
| Rate for Payer: Clover Medicare Advantage |
$37.30
|
| Rate for Payer: EmblemHealth Commercial |
$117.78
|
| Rate for Payer: Humana Medicare Advantage |
$40.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$39.26
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$41.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$39.26
|
|
|
NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$340.75
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
3032050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.11 |
| Max. Negotiated Rate |
$51.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.11
|
|
|
NATURA DRAINABLE PUCH INVISICL
|
Facility
|
IP
|
$13.99
|
|
| Hospital Charge Code |
270683664
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$2.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.10
|
|
|
NATURA DRAINABLE PUCH INVISICL
|
Facility
|
OP
|
$13.99
|
|
| Hospital Charge Code |
270683664
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$7.00 |
| Rate for Payer: Aetna Commercial |
$4.20
|
| Rate for Payer: Aetna Medicare Advantage |
$4.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.57
|
| Rate for Payer: Cigna Commercial |
$7.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.82
|
| Rate for Payer: Oxford Commercial |
$7.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.00
|
|
|
NATURALYTE 0K 2.25CA 1MG 1GAL
|
Facility
|
OP
|
$9.00
|
|
| Hospital Charge Code |
270647856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna Commercial |
$2.70
|
| Rate for Payer: Aetna Medicare Advantage |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.29
|
| Rate for Payer: Cigna Commercial |
$4.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.17
|
| Rate for Payer: Oxford Commercial |
$4.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.50
|
|
|
NATURALYTE 0K 2.25CA 1MG 1GAL
|
Facility
|
IP
|
$9.00
|
|
| Hospital Charge Code |
270647856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.35
|
|
|
NATURALYTE ACID
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
270657775
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
|
|
NATURALYTE ACID
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
270657775
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.83
|
| Rate for Payer: Cigna Commercial |
$7.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.95
|
| Rate for Payer: Oxford Commercial |
$7.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.50
|
|
|
NATURALYTE, ACID CONCENTRATE
|
Facility
|
OP
|
$51.50
|
|
| Hospital Charge Code |
270658808
|
|
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
|
|
|
NATURALYTE, ACID CONCENTRATE
|
Facility
|
IP
|
$51.50
|
|
| Hospital Charge Code |
270658808
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$7.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.72
|
|
|
NATURALYTE ACID CONCENTRATE 2K
|
Facility
|
IP
|
$11.88
|
|
| Hospital Charge Code |
270649619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$1.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.78
|
|
|
NATURALYTE ACID CONCENTRATE 2K
|
Facility
|
OP
|
$11.88
|
|
| Hospital Charge Code |
270649619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$5.94 |
| Rate for Payer: Aetna Commercial |
$3.56
|
| Rate for Payer: Aetna Medicare Advantage |
$3.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.03
|
| Rate for Payer: Cigna Commercial |
$5.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.54
|
| Rate for Payer: Oxford Commercial |
$5.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.94
|
|
|
NATURALYTE BICARBONATE LIQUID
|
Facility
|
OP
|
$11.88
|
|
| Hospital Charge Code |
270649621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$5.94 |
| Rate for Payer: Aetna Commercial |
$3.56
|
| Rate for Payer: Aetna Medicare Advantage |
$3.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.03
|
| Rate for Payer: Cigna Commercial |
$5.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.54
|
| Rate for Payer: Oxford Commercial |
$5.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.94
|
|
|
NATURALYTE BICARBONATE LIQUID
|
Facility
|
IP
|
$11.88
|
|
| Hospital Charge Code |
270649621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$1.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.78
|
|
|
NA,URINE RANDOM
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
HCPCS 84300
|
| Hospital Charge Code |
38479039
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.55
|
|
|
NA,URINE RANDOM
|
Facility
|
OP
|
$117.00
|
|
|
Service Code
|
HCPCS 84300
|
| Hospital Charge Code |
38479039
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare Advantage |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.54
|
| Rate for Payer: Cigna Commercial |
$5.06
|
| Rate for Payer: Cigna Medicare Advantage |
$2.53
|
| Rate for Payer: Clover Medicare Advantage |
$4.81
|
| Rate for Payer: EmblemHealth Commercial |
$15.18
|
| Rate for Payer: Humana Medicare Advantage |
$5.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.21
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.06
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.06
|
|
|
NAVANE/10MG/CAP
|
Facility
|
OP
|
$5.00
|
|
| Hospital Charge Code |
60633508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.27
|
| Rate for Payer: Cigna Commercial |
$2.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.65
|
| Rate for Payer: Oxford Commercial |
$2.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.50
|
|
|
NAVANE/10MG/CAP
|
Facility
|
IP
|
$5.00
|
|
| Hospital Charge Code |
60633508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
|
|
NAVANE/1MG/CAP
|
Facility
|
IP
|
$3.00
|
|
| Hospital Charge Code |
60633509
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
|
|
NAVANE/1MG/CAP
|
Facility
|
OP
|
$3.00
|
|
| Hospital Charge Code |
60633509
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare Advantage |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.77
|
| Rate for Payer: Cigna Commercial |
$1.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.39
|
| Rate for Payer: Oxford Commercial |
$1.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.50
|
|