|
NEEDLE ECHO BRIGHT 22G STIMULA
|
Facility
|
OP
|
$68.50
|
|
| Hospital Charge Code |
270676894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.90 |
| Max. Negotiated Rate |
$34.25 |
| Rate for Payer: Aetna Commercial |
$20.55
|
| Rate for Payer: Aetna Medicare Advantage |
$20.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.47
|
| Rate for Payer: Cigna Commercial |
$34.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.90
|
| Rate for Payer: Oxford Commercial |
$34.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.25
|
|
|
NEEDLE ECHOGENIC 9cm
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
270669623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
|
|
NEEDLE ECHOGENIC 9cm
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
270669623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$12.50 |
| Rate for Payer: Aetna Commercial |
$7.50
|
| Rate for Payer: Aetna Medicare Advantage |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.38
|
| Rate for Payer: Cigna Commercial |
$12.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.25
|
| Rate for Payer: Oxford Commercial |
$12.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.50
|
|
|
NEEDLE ECHO STIM 360 20gaX4in
|
Facility
|
OP
|
$69.24
|
|
| Hospital Charge Code |
270679864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$34.62 |
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Medicare Advantage |
$20.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.66
|
| Rate for Payer: Cigna Commercial |
$34.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.00
|
| Rate for Payer: Oxford Commercial |
$34.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.62
|
|
|
NEEDLE ECHO STIM 360 20gaX4in
|
Facility
|
IP
|
$69.24
|
|
| Hospital Charge Code |
270679864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.39 |
| Max. Negotiated Rate |
$10.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.39
|
|
|
NEEDLE ECHO STIM 360 20gaX6in
|
Facility
|
OP
|
$73.40
|
|
| Hospital Charge Code |
270679863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$36.70 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare Advantage |
$22.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.72
|
| Rate for Payer: Cigna Commercial |
$36.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.54
|
| Rate for Payer: Oxford Commercial |
$36.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.70
|
|
|
NEEDLE ECHO STIM 360 20gaX6in
|
Facility
|
IP
|
$73.40
|
|
| Hospital Charge Code |
270679863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.01 |
| Max. Negotiated Rate |
$11.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.01
|
|
|
NEEDLE ECHOTIP AMNIOC 12CM
|
Facility
|
IP
|
$103.25
|
|
| Hospital Charge Code |
270600578
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$15.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.49
|
|
|
NEEDLE ECHOTIP AMNIOC 12CM
|
Facility
|
OP
|
$103.25
|
|
| Hospital Charge Code |
270600578
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$51.62 |
| Rate for Payer: Aetna Commercial |
$30.98
|
| Rate for Payer: Aetna Medicare Advantage |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.33
|
| Rate for Payer: Cigna Commercial |
$51.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.42
|
| Rate for Payer: Oxford Commercial |
$51.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$51.62
|
|
|
NEEDLE ECHOTIP AMNIOC 15CM
|
Facility
|
IP
|
$103.25
|
|
| Hospital Charge Code |
270600579
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$15.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.49
|
|
|
NEEDLE ECHOTIP AMNIOC 15CM
|
Facility
|
OP
|
$103.25
|
|
| Hospital Charge Code |
270600579
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$51.62 |
| Rate for Payer: Aetna Commercial |
$30.98
|
| Rate for Payer: Aetna Medicare Advantage |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.33
|
| Rate for Payer: Cigna Commercial |
$51.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.42
|
| Rate for Payer: Oxford Commercial |
$51.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$51.62
|
|
|
NEEDLE ECHOTIP ULTA 19G G31520
|
Facility
|
IP
|
$1,311.00
|
|
| Hospital Charge Code |
270642280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$196.65 |
| Max. Negotiated Rate |
$196.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$196.65
|
|
|
NEEDLE ECHOTIP ULTA 19G G31520
|
Facility
|
OP
|
$1,311.00
|
|
| Hospital Charge Code |
270642280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.43 |
| Max. Negotiated Rate |
$655.50 |
| Rate for Payer: Aetna Commercial |
$393.30
|
| Rate for Payer: Aetna Medicare Advantage |
$393.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$334.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$334.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$334.31
|
| Rate for Payer: Cigna Commercial |
$655.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$170.43
|
| Rate for Payer: Oxford Commercial |
$655.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$196.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$655.50
|
|
|
NEEDLE ECHOTIP ULTRASO ECHO-25
|
Facility
|
IP
|
$1,349.95
|
|
| Hospital Charge Code |
270633345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.49 |
| Max. Negotiated Rate |
$202.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.49
|
|
|
NEEDLE ECHOTIP ULTRASO ECHO-25
|
Facility
|
OP
|
$1,349.95
|
|
| Hospital Charge Code |
270633345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.49 |
| Max. Negotiated Rate |
$674.98 |
| Rate for Payer: Aetna Commercial |
$404.99
|
| Rate for Payer: Aetna Medicare Advantage |
$404.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$344.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$344.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$344.24
|
| Rate for Payer: Cigna Commercial |
$674.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$175.49
|
| Rate for Payer: Oxford Commercial |
$674.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$674.98
|
|
|
NEEDLE ELECTRD 2.0 COLTIP 0118
|
Facility
|
OP
|
$75.07
|
|
| Hospital Charge Code |
270635317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.76 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$22.52
|
| Rate for Payer: Aetna Medicare Advantage |
$22.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.14
|
| Rate for Payer: Cigna Commercial |
$37.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.76
|
| Rate for Payer: Oxford Commercial |
$37.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.53
|
|
|
NEEDLE ELECTRD 2.0 COLTIP 0118
|
Facility
|
IP
|
$75.07
|
|
| Hospital Charge Code |
270635317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.26 |
| Max. Negotiated Rate |
$11.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.26
|
|
|
NEEDLE ELECTRODE
|
Facility
|
IP
|
$471.00
|
|
| Hospital Charge Code |
270331275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.65 |
| Max. Negotiated Rate |
$70.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.65
|
|
|
NEEDLE ELECTRODE
|
Facility
|
OP
|
$471.00
|
|
| Hospital Charge Code |
270331275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.23 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$141.30
|
| Rate for Payer: Aetna Medicare Advantage |
$141.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$120.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$120.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$120.11
|
| Rate for Payer: Cigna Commercial |
$235.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.23
|
| Rate for Payer: Oxford Commercial |
$235.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$235.50
|
|
|
NEEDLE ELECTRODE 1
|
Facility
|
OP
|
$5.69
|
|
| Hospital Charge Code |
270645140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Aetna Commercial |
$1.71
|
| Rate for Payer: Aetna Medicare Advantage |
$1.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.45
|
| Rate for Payer: Cigna Commercial |
$2.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.74
|
| Rate for Payer: Oxford Commercial |
$2.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.85
|
|
|
NEEDLE ELECTRODE 1
|
Facility
|
OP
|
$13.65
|
|
| Hospital Charge Code |
270060875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.77 |
| Max. Negotiated Rate |
$6.83 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.48
|
| Rate for Payer: Cigna Commercial |
$6.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.77
|
| Rate for Payer: Oxford Commercial |
$6.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.83
|
|
|
NEEDLE ELECTRODE 1
|
Facility
|
IP
|
$5.69
|
|
| Hospital Charge Code |
270645140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
|
|
NEEDLE ELECTRODE 1
|
Facility
|
IP
|
$13.65
|
|
| Hospital Charge Code |
270060875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
|
|
NEEDLE ELECTROMYOGRAPHY,UNILA
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
HCPCS 95860
|
| Hospital Charge Code |
5500044
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$53.55 |
| Max. Negotiated Rate |
$53.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.55
|
|
|
NEEDLE ELECTROMYOGRAPHY,UNILA
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
HCPCS 95860
|
| Hospital Charge Code |
5500044
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$1,673.00 |
| Rate for Payer: Aetna Commercial |
$107.10
|
| Rate for Payer: Aetna Medicare Advantage |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$212.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.03
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.41
|
| Rate for Payer: Oxford Commercial |
$1,474.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,673.00
|
|