|
NUTRIVENT
|
Facility
|
IP
|
$28.00
|
|
| Hospital Charge Code |
60634854
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
|
|
NUT SALVATION
|
Facility
|
IP
|
$115.00
|
|
| Hospital Charge Code |
270684461
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
NUT SALVATION
|
Facility
|
OP
|
$115.00
|
|
| Hospital Charge Code |
270684461
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$34.50
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Oxford Commercial |
$57.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$57.50
|
|
|
NUTS ORTHO BONE
|
Facility
|
IP
|
$208.15
|
|
| Hospital Charge Code |
270691903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.22 |
| Max. Negotiated Rate |
$31.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.22
|
|
|
NUTS ORTHO BONE
|
Facility
|
OP
|
$208.15
|
|
| Hospital Charge Code |
270691903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.06 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$62.45
|
| Rate for Payer: Aetna Medicare Advantage |
$62.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.08
|
| Rate for Payer: Cigna Commercial |
$104.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.06
|
| Rate for Payer: Oxford Commercial |
$104.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$104.08
|
|
|
NUT SPEED
|
Facility
|
OP
|
$704.50
|
|
| Hospital Charge Code |
270678088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.67 |
| Max. Negotiated Rate |
$352.25 |
| Rate for Payer: Aetna Commercial |
$211.35
|
| Rate for Payer: Aetna Medicare Advantage |
$211.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$179.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$179.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$179.65
|
| Rate for Payer: Cigna Commercial |
$352.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$170.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.67
|
|
|
NUT SPEED
|
Facility
|
IP
|
$704.50
|
|
| Hospital Charge Code |
270678088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.67 |
| Max. Negotiated Rate |
$170.49 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$170.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.67
|
|
|
NUT SYN SPRG SM EXT FIX 395-58
|
Facility
|
IP
|
$128.00
|
|
| Hospital Charge Code |
270601806
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$30.98 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
NUT SYN SPRG SM EXT FIX 395-58
|
Facility
|
OP
|
$128.00
|
|
| Hospital Charge Code |
270601806
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$38.40
|
| Rate for Payer: Aetna Medicare Advantage |
$38.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.64
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
NUT/WASHER DPY SPHERICAL 10095
|
Facility
|
OP
|
$430.45
|
|
| Hospital Charge Code |
270612442
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.96 |
| Max. Negotiated Rate |
$215.22 |
| Rate for Payer: Aetna Commercial |
$129.13
|
| Rate for Payer: Aetna Medicare Advantage |
$129.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$109.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$109.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$109.76
|
| Rate for Payer: Cigna Commercial |
$215.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.96
|
| Rate for Payer: Oxford Commercial |
$215.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$215.22
|
|
|
NUT/WASHER DPY SPHERICAL 10095
|
Facility
|
IP
|
$430.45
|
|
| Hospital Charge Code |
270612442
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.57 |
| Max. Negotiated Rate |
$64.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.57
|
|
|
NUT WHITE F/FLASHPAK INSTAL
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
270639737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Aetna Commercial |
$6.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.10
|
| Rate for Payer: Cigna Commercial |
$10.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.60
|
| Rate for Payer: Oxford Commercial |
$10.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.00
|
|
|
NUT WHITE F/FLASHPAK INSTAL
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
270639737
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
|
|
NV ENDOTRACHEAL TUBE 7MM EMG
|
Facility
|
OP
|
$1,850.00
|
|
| Hospital Charge Code |
270694490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna Commercial |
$555.00
|
| Rate for Payer: Aetna Medicare Advantage |
$555.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.75
|
| Rate for Payer: Cigna Commercial |
$925.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.50
|
| Rate for Payer: Oxford Commercial |
$925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$925.00
|
|
|
NV ENDOTRACHEAL TUBE 7MM EMG
|
Facility
|
IP
|
$1,850.00
|
|
| Hospital Charge Code |
270694490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$277.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
NVM5 EMG ENDOTRACH TUBE 7MM
|
Facility
|
OP
|
$1,850.00
|
|
| Hospital Charge Code |
270694492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna Commercial |
$555.00
|
| Rate for Payer: Aetna Medicare Advantage |
$555.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.75
|
| Rate for Payer: Cigna Commercial |
$925.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.50
|
| Rate for Payer: Oxford Commercial |
$925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$925.00
|
|
|
NVM5 EMG ENDOTRACH TUBE 7MM
|
Facility
|
IP
|
$1,850.00
|
|
| Hospital Charge Code |
270694492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$277.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
NVM5 NEEDLE MODULE MEP EMG
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270696790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.00
|
|
|
NVM5 NEEDLE MODULE MEP EMG
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270696790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$715.00 |
| Max. Negotiated Rate |
$2,750.00 |
| Rate for Payer: Aetna Commercial |
$1,650.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,402.50
|
| Rate for Payer: Cigna Commercial |
$2,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$715.00
|
| Rate for Payer: Oxford Commercial |
$2,750.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,750.00
|
|
|
NXGN A/P WDG PRCT TIB PLT SZ 5
|
Facility
|
IP
|
$13,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,980.00 |
| Max. Negotiated Rate |
$3,194.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,640.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,194.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,980.00
|
|
|
NXGN A/P WDG PRCT TIB PLT SZ 5
|
Facility
|
OP
|
$13,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,980.00 |
| Max. Negotiated Rate |
$6,600.00 |
| Rate for Payer: Aetna Commercial |
$3,960.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,960.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,366.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,366.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,640.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,366.00
|
| Rate for Payer: Cigna Commercial |
$6,600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,194.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,980.00
|
|
|
NXGN ARTSUR CD3-4 12MM LPSFLX
|
Facility
|
OP
|
$5,862.10
|
|
| Hospital Charge Code |
270668703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$879.32 |
| Max. Negotiated Rate |
$2,931.05 |
| Rate for Payer: Aetna Commercial |
$1,758.63
|
| Rate for Payer: Aetna Medicare Advantage |
$1,758.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,494.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,494.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,172.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,494.84
|
| Rate for Payer: Cigna Commercial |
$2,931.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,418.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$879.32
|
|
|
NXGN ARTSUR CD3-4 12MM LPSFLX
|
Facility
|
IP
|
$5,862.10
|
|
| Hospital Charge Code |
270668703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$879.32 |
| Max. Negotiated Rate |
$1,418.63 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,172.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,418.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$879.32
|
|
|
NXGN LCCK ART SURF GRN 23MM
|
Facility
|
OP
|
$12,840.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686882
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,926.00 |
| Max. Negotiated Rate |
$6,420.00 |
| Rate for Payer: Aetna Commercial |
$3,852.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,852.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,274.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,274.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,568.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,274.20
|
| Rate for Payer: Cigna Commercial |
$6,420.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,107.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,926.00
|
|
|
NXGN LCCK ART SURF GRN 23MM
|
Facility
|
IP
|
$12,840.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686882
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,926.00 |
| Max. Negotiated Rate |
$3,107.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,568.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,107.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,926.00
|
|