|
PROBE/CRITTER COVERS
|
Facility
|
IP
|
$142.55
|
|
| Hospital Charge Code |
270662651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$21.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.38
|
|
|
PROBE/CRITTER COVERS
|
Facility
|
OP
|
$142.55
|
|
| Hospital Charge Code |
270662651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$71.28 |
| Rate for Payer: Aetna Commercial |
$42.77
|
| Rate for Payer: Aetna Medicare Advantage |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.35
|
| Rate for Payer: Cigna Commercial |
$71.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.53
|
| Rate for Payer: Oxford Commercial |
$71.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$71.28
|
|
|
PROBE CURETTE TITANIUM WITH VA
|
Facility
|
IP
|
$2,425.00
|
|
| Hospital Charge Code |
270679597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.75 |
| Max. Negotiated Rate |
$363.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.75
|
|
|
PROBE CURETTE TITANIUM WITH VA
|
Facility
|
OP
|
$2,425.00
|
|
| Hospital Charge Code |
270679597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$315.25 |
| Max. Negotiated Rate |
$1,212.50 |
| Rate for Payer: Cigna Commercial |
$1,212.50
|
| Rate for Payer: Aetna Commercial |
$727.50
|
| Rate for Payer: Aetna Medicare Advantage |
$727.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$618.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$618.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$618.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$315.25
|
| Rate for Payer: Oxford Commercial |
$1,212.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,212.50
|
|
|
PROBE CURVED BLADE 5MM-32CM
|
Facility
|
IP
|
$522.00
|
|
| Hospital Charge Code |
270335401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.30 |
| Max. Negotiated Rate |
$78.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.30
|
|
|
PROBE CURVED BLADE 5MM-32CM
|
Facility
|
OP
|
$522.00
|
|
| Hospital Charge Code |
270335401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$67.86 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$156.60
|
| Rate for Payer: Aetna Medicare Advantage |
$156.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.11
|
| Rate for Payer: Cigna Commercial |
$261.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.86
|
| Rate for Payer: Oxford Commercial |
$261.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$261.00
|
|
|
PROBE CYLINDERICAL TI
|
Facility
|
IP
|
$2,025.00
|
|
| Hospital Charge Code |
270678536
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
|
|
PROBE CYLINDERICAL TI
|
Facility
|
OP
|
$2,025.00
|
|
| Hospital Charge Code |
270678536
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.25 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$607.50
|
| Rate for Payer: Aetna Medicare Advantage |
$607.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$516.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$516.38
|
| Rate for Payer: Cigna Commercial |
$1,012.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$263.25
|
| Rate for Payer: Oxford Commercial |
$1,012.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,012.50
|
|
|
PROBE DISPOSABLE ADULT
|
Facility
|
OP
|
$28.00
|
|
| Hospital Charge Code |
270669532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$8.40
|
| Rate for Payer: Aetna Medicare Advantage |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.14
|
| Rate for Payer: Cigna Commercial |
$14.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.64
|
| Rate for Payer: Oxford Commercial |
$14.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.00
|
|
|
PROBE DISPOSABLE ADULT
|
Facility
|
IP
|
$28.00
|
|
| Hospital Charge Code |
270669532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
|
|
PROBE DISPOSABLE VTI DOPPLER
|
Facility
|
OP
|
$499.00
|
|
| Hospital Charge Code |
270657530
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$64.87 |
| Max. Negotiated Rate |
$249.50 |
| Rate for Payer: Aetna Commercial |
$149.70
|
| Rate for Payer: Aetna Medicare Advantage |
$149.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.25
|
| Rate for Payer: Cigna Commercial |
$249.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.87
|
| Rate for Payer: Oxford Commercial |
$249.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$249.50
|
|
|
PROBE DISPOSABLE VTI DOPPLER
|
Facility
|
IP
|
$499.00
|
|
| Hospital Charge Code |
270657530
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$74.85 |
| Max. Negotiated Rate |
$74.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.85
|
|
|
PROBE DPPLR PENCIL 7' 9.2 MHZ
|
Facility
|
IP
|
$720.00
|
|
| Hospital Charge Code |
270658140
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.00
|
|
|
PROBE DPPLR PENCIL 7' 9.2 MHZ
|
Facility
|
OP
|
$720.00
|
|
| Hospital Charge Code |
270658140
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$216.00
|
| Rate for Payer: Aetna Medicare Advantage |
$216.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$183.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$183.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$183.60
|
| Rate for Payer: Cigna Commercial |
$360.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.60
|
| Rate for Payer: Oxford Commercial |
$360.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$360.00
|
|
|
PROBE EFLEX INTEGRATED CABLE
|
Facility
|
IP
|
$2,620.00
|
|
| Hospital Charge Code |
270670485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$393.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$393.00
|
|
|
PROBE EFLEX INTEGRATED CABLE
|
Facility
|
OP
|
$2,620.00
|
|
| Hospital Charge Code |
270670485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$340.60 |
| Max. Negotiated Rate |
$1,310.00 |
| Rate for Payer: Aetna Commercial |
$786.00
|
| Rate for Payer: Aetna Medicare Advantage |
$786.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$668.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$668.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$668.10
|
| Rate for Payer: Cigna Commercial |
$1,310.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$340.60
|
| Rate for Payer: Oxford Commercial |
$1,310.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$393.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,310.00
|
|
|
PROBE ELEC SURG W HAND 7205565
|
Facility
|
IP
|
$245.65
|
|
| Hospital Charge Code |
270616859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$36.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.85
|
|
|
PROBE ELEC SURG W HAND 7205565
|
Facility
|
OP
|
$245.65
|
|
| Hospital Charge Code |
270616859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.93 |
| Max. Negotiated Rate |
$122.83 |
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: Aetna Medicare Advantage |
$73.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.64
|
| Rate for Payer: Cigna Commercial |
$122.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.93
|
| Rate for Payer: Oxford Commercial |
$122.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$122.83
|
|
|
PROBE ELECTROHYDRAUL 1.6F
|
Facility
|
OP
|
$1,200.00
|
|
| Hospital Charge Code |
270600274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Aetna Commercial |
$360.00
|
| Rate for Payer: Aetna Medicare Advantage |
$360.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$306.00
|
| Rate for Payer: Cigna Commercial |
$600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$156.00
|
| Rate for Payer: Oxford Commercial |
$600.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$600.00
|
|
|
PROBE ELECTROHYDRAUL 1.6F
|
Facility
|
IP
|
$1,200.00
|
|
| Hospital Charge Code |
270600274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
|
|
PROBE ELECTROHYDRAUL 3.0FR
|
Facility
|
OP
|
$1,371.25
|
|
| Hospital Charge Code |
270600275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.26 |
| Max. Negotiated Rate |
$685.62 |
| Rate for Payer: Aetna Commercial |
$411.38
|
| Rate for Payer: Aetna Medicare Advantage |
$411.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$349.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$349.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$349.67
|
| Rate for Payer: Cigna Commercial |
$685.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.26
|
| Rate for Payer: Oxford Commercial |
$685.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$205.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$685.62
|
|
|
PROBE ELECTROHYDRAUL 3.0FR
|
Facility
|
IP
|
$1,371.25
|
|
| Hospital Charge Code |
270600275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$205.69 |
| Max. Negotiated Rate |
$205.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$205.69
|
|
|
PROBE ELECTROHYDRAUL 4.5F
|
Facility
|
IP
|
$1,296.00
|
|
| Hospital Charge Code |
270600289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.40 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
|
|
PROBE ELECTROHYDRAUL 4.5F
|
Facility
|
OP
|
$1,296.00
|
|
| Hospital Charge Code |
270600289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.48 |
| Max. Negotiated Rate |
$648.00 |
| Rate for Payer: Aetna Commercial |
$388.80
|
| Rate for Payer: Aetna Medicare Advantage |
$388.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$330.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$330.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$330.48
|
| Rate for Payer: Cigna Commercial |
$648.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$168.48
|
| Rate for Payer: Oxford Commercial |
$648.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$648.00
|
|
|
PROBE ELECTROHYDRAUL 7.0F
|
Facility
|
OP
|
$1,437.50
|
|
| Hospital Charge Code |
270600291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$186.88 |
| Max. Negotiated Rate |
$718.75 |
| Rate for Payer: Aetna Commercial |
$431.25
|
| Rate for Payer: Aetna Medicare Advantage |
$431.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$366.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$366.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$366.56
|
| Rate for Payer: Cigna Commercial |
$718.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$186.88
|
| Rate for Payer: Oxford Commercial |
$718.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$718.75
|
|