|
RESOLVE 10FR PIGTAIL UNIV.
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270654364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270653920R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
IP
|
$328.00
|
|
| Hospital Charge Code |
270653920S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$49.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270653920S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
IP
|
$328.00
|
|
| Hospital Charge Code |
270653920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$49.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
IP
|
$328.00
|
|
| Hospital Charge Code |
270653920R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$49.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270653920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
IP
|
$285.00
|
|
| Hospital Charge Code |
270653920N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.75 |
| Max. Negotiated Rate |
$42.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.75
|
|
|
RESOLVE 8FR PIGTAIL UNIVERSAL
|
Facility
|
OP
|
$285.00
|
|
| Hospital Charge Code |
270653920N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.05 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$85.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.67
|
| Rate for Payer: Cigna Commercial |
$142.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.05
|
| Rate for Payer: Oxford Commercial |
$142.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$142.50
|
|
|
RESOLVE 8FR STR UNI DRAIN CATH
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
2709003658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.45 |
| Max. Negotiated Rate |
$132.50 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare Advantage |
$79.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.58
|
| Rate for Payer: Cigna Commercial |
$132.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.45
|
| Rate for Payer: Oxford Commercial |
$132.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.50
|
|
|
RESOLVE 8FR STR UNI DRAIN CATH
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
2709003658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
|
|
RESOLVE NL 8FR STRAIGHT UNIVER
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
270658212
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$64.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$53.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
|
|
RESOLVE NL 8FR STRAIGHT UNIVER
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
270658212
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$132.50 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare Advantage |
$79.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$53.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.58
|
| Rate for Payer: Cigna Commercial |
$132.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
|
|
RESOURCE PUDDING
|
Facility
|
IP
|
$5.00
|
|
| Hospital Charge Code |
60635165
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
|
|
RESOURCE PUDDING
|
Facility
|
OP
|
$5.00
|
|
| Hospital Charge Code |
60635165
|
|
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
|
|
|
RESP ALLERGY PROF REG I I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82785
|
| Hospital Charge Code |
39990069A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$53.33
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.31
|
| Rate for Payer: Cigna Commercial |
$16.46
|
| Rate for Payer: Cigna Medicare Advantage |
$8.23
|
| Rate for Payer: Clover Medicare Advantage |
$15.64
|
| Rate for Payer: EmblemHealth Commercial |
$49.38
|
| Rate for Payer: Humana Medicare Advantage |
$16.95
|
| 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 |
$16.46
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$17.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.46
|
|
|
RESP ALLERGY PROF REG I I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82785
|
| Hospital Charge Code |
39990069A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
RESP ALLERGY PROF REG I II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069B
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| 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 |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RESP ALLERGY PROF REG I II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069B
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
RESP ALLERGY PROF REG I III
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069C
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| 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 |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RESP ALLERGY PROF REG I III
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069C
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
RESP ALLERGY PROF REG I IV
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069D
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
RESP ALLERGY PROF REG I IV
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069D
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| 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 |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RESP ALLERGY PROF REG I IX
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069I
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| 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 |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RESP ALLERGY PROF REG I IX
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990069I
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|