|
SNARE EN SYSTEM 6FR 9-15MM
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
270658292N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$227.50 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$525.00
|
| Rate for Payer: Aetna Medicare Advantage |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$446.25
|
| Rate for Payer: Cigna Commercial |
$875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$227.50
|
| Rate for Payer: Oxford Commercial |
$875.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$875.00
|
|
|
SNARE EXACTO COLD 00711115
|
Facility
|
IP
|
$60.00
|
|
| Hospital Charge Code |
270663453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
SNARE EXACTO COLD 00711115
|
Facility
|
OP
|
$60.00
|
|
| Hospital Charge Code |
270663453
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$18.00
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.80
|
| Rate for Payer: Oxford Commercial |
$30.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.00
|
|
|
SNARE HEXAGONAL SMAL 13MM
|
Facility
|
OP
|
$65.75
|
|
| Hospital Charge Code |
270676499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$32.88 |
| Rate for Payer: Aetna Commercial |
$19.73
|
| Rate for Payer: Aetna Medicare Advantage |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.77
|
| Rate for Payer: Cigna Commercial |
$32.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.55
|
| Rate for Payer: Oxford Commercial |
$32.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.88
|
|
|
SNARE HEXAGONAL SMAL 13MM
|
Facility
|
IP
|
$65.75
|
|
| Hospital Charge Code |
270676499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$9.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.86
|
|
|
SNARE HEXAGONAL TRX BX00711113
|
Facility
|
IP
|
$125.00
|
|
| Hospital Charge Code |
270645644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
SNARE HEXAGONAL TRX BX00711113
|
Facility
|
OP
|
$125.00
|
|
| Hospital Charge Code |
270645644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$62.50 |
| Rate for Payer: Aetna Commercial |
$37.50
|
| Rate for Payer: Aetna Medicare Advantage |
$37.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.88
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.25
|
| Rate for Payer: Oxford Commercial |
$62.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.50
|
|
|
SNARE MCV CAPTIFLEX 6240-6248
|
Facility
|
OP
|
$274.45
|
|
| Hospital Charge Code |
270603902
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.68 |
| Max. Negotiated Rate |
$137.22 |
| Rate for Payer: Aetna Commercial |
$82.33
|
| Rate for Payer: Aetna Medicare Advantage |
$82.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$69.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$69.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$69.98
|
| Rate for Payer: Cigna Commercial |
$137.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.68
|
| Rate for Payer: Oxford Commercial |
$137.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.22
|
|
|
SNARE MCV CAPTIFLEX 6240-6248
|
Facility
|
IP
|
$274.45
|
|
| Hospital Charge Code |
270603902
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.17 |
| Max. Negotiated Rate |
$41.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.17
|
|
|
SNARE MCV CAPTOFLEX 6242
|
Facility
|
OP
|
$124.85
|
|
| Hospital Charge Code |
270603143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare Advantage |
$37.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.84
|
| Rate for Payer: Cigna Commercial |
$62.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.23
|
| Rate for Payer: Oxford Commercial |
$62.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.42
|
|
|
SNARE MCV CAPTOFLEX 6242
|
Facility
|
IP
|
$124.85
|
|
| Hospital Charge Code |
270603143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|
|
SNARE MCV CAPTOFLEX MICRO 6243
|
Facility
|
IP
|
$124.85
|
|
| Hospital Charge Code |
270611333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|
|
SNARE MCV CAPTOFLEX MICRO 6243
|
Facility
|
OP
|
$124.85
|
|
| Hospital Charge Code |
270611333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare Advantage |
$37.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.84
|
| Rate for Payer: Cigna Commercial |
$62.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.23
|
| Rate for Payer: Oxford Commercial |
$62.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.42
|
|
|
SNARE MCV POLYPEC MM OVAL 6247
|
Facility
|
OP
|
$124.85
|
|
| Hospital Charge Code |
270610581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare Advantage |
$37.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.84
|
| Rate for Payer: Cigna Commercial |
$62.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.23
|
| Rate for Payer: Oxford Commercial |
$62.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.42
|
|
|
SNARE MCV POLYPEC MM OVAL 6247
|
Facility
|
IP
|
$124.85
|
|
| Hospital Charge Code |
270610581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|
|
SNARE MCV POLYPEC STD OV 6240
|
Facility
|
IP
|
$124.85
|
|
| Hospital Charge Code |
270608226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|
|
SNARE MCV POLYPEC STD OV 6240
|
Facility
|
OP
|
$124.85
|
|
| Hospital Charge Code |
270608226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare Advantage |
$37.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.84
|
| Rate for Payer: Cigna Commercial |
$62.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.23
|
| Rate for Payer: Oxford Commercial |
$62.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.42
|
|
|
SNARE MCV POLYPECT 240CM 60418
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270606569
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SNARE MCV POLYPECT 240CM 60418
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270606569
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.10
|
| Rate for Payer: Oxford Commercial |
$69.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$69.62
|
|
|
SNARE MCV POLYPECT 60412
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270600927
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.10
|
| Rate for Payer: Oxford Commercial |
$69.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$69.62
|
|
|
SNARE MCV POLYPECT 60412
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270600927
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
SNARE MCV ROTATABLE 20MM 6183
|
Facility
|
IP
|
$193.65
|
|
| Hospital Charge Code |
270628381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.05 |
| Max. Negotiated Rate |
$29.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.05
|
|
|
SNARE MCV ROTATABLE 20MM 6183
|
Facility
|
OP
|
$193.65
|
|
| Hospital Charge Code |
270628381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.17 |
| Max. Negotiated Rate |
$96.83 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare Advantage |
$58.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.38
|
| Rate for Payer: Cigna Commercial |
$96.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.17
|
| Rate for Payer: Oxford Commercial |
$96.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$96.83
|
|
|
SNARE MCV SENSATION STD 626920
|
Facility
|
OP
|
$124.85
|
|
| Hospital Charge Code |
270603904
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare Advantage |
$37.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.84
|
| Rate for Payer: Cigna Commercial |
$62.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.23
|
| Rate for Payer: Oxford Commercial |
$62.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.42
|
|
|
SNARE MCV SENSATION STD 626920
|
Facility
|
IP
|
$124.85
|
|
| Hospital Charge Code |
270603904
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.73
|
|