|
TUBE CONNECTING 18
|
Facility
|
IP
|
$1.29
|
|
| Hospital Charge Code |
270649278
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.19
|
|
|
TUBE CONNECTING 18
|
Facility
|
OP
|
$1.29
|
|
| Hospital Charge Code |
270649278
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Commercial |
$0.39
|
| Rate for Payer: Aetna Medicare Advantage |
$0.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.33
|
| Rate for Payer: Cigna Commercial |
$0.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.17
|
| Rate for Payer: Oxford Commercial |
$0.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.65
|
|
|
TUBE CONNECTING CCTU140-30-ST
|
Facility
|
IP
|
$99.25
|
|
| Hospital Charge Code |
270601473
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.89 |
| Max. Negotiated Rate |
$14.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.89
|
|
|
TUBE CONNECTING CCTU140-30-ST
|
Facility
|
OP
|
$99.25
|
|
| Hospital Charge Code |
270601473
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.90 |
| Max. Negotiated Rate |
$49.62 |
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: Aetna Medicare Advantage |
$29.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.31
|
| Rate for Payer: Cigna Commercial |
$49.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.90
|
| Rate for Payer: Oxford Commercial |
$49.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.62
|
|
|
TUBE CONNECTING NONCONDUCT 20'
|
Facility
|
OP
|
$1.23
|
|
| Hospital Charge Code |
270649279N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.62 |
| Rate for Payer: Aetna Commercial |
$0.37
|
| Rate for Payer: Aetna Medicare Advantage |
$0.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.31
|
| Rate for Payer: Cigna Commercial |
$0.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.16
|
| Rate for Payer: Oxford Commercial |
$0.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.62
|
|
|
TUBE CONNECTING NONCONDUCT 20'
|
Facility
|
OP
|
$5.63
|
|
| Hospital Charge Code |
270649279S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$2.81 |
| Rate for Payer: Aetna Commercial |
$1.69
|
| Rate for Payer: Aetna Medicare Advantage |
$1.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.44
|
| Rate for Payer: Cigna Commercial |
$2.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.73
|
| Rate for Payer: Oxford Commercial |
$2.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.81
|
|
|
TUBE CONNECTING NONCONDUCT 20'
|
Facility
|
IP
|
$5.63
|
|
| Hospital Charge Code |
270649279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.84
|
|
|
TUBE CONNECTING NONCONDUCT 20'
|
Facility
|
IP
|
$5.63
|
|
| Hospital Charge Code |
270649279S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.84
|
|
|
TUBE CONNECTING NONCONDUCT 20'
|
Facility
|
IP
|
$1.23
|
|
| Hospital Charge Code |
270649279N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.18
|
|
|
TUBE CONNECTING NONCONDUCT 20'
|
Facility
|
OP
|
$5.63
|
|
| Hospital Charge Code |
270649279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$2.81 |
| Rate for Payer: Aetna Commercial |
$1.69
|
| Rate for Payer: Aetna Medicare Advantage |
$1.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.44
|
| Rate for Payer: Cigna Commercial |
$2.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.73
|
| Rate for Payer: Oxford Commercial |
$2.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.81
|
|
|
TUBE CONNECTNG 14FR W/STOPCOCK
|
Facility
|
OP
|
$63.75
|
|
| Hospital Charge Code |
270623768
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$31.88 |
| Rate for Payer: Aetna Commercial |
$19.12
|
| Rate for Payer: Aetna Medicare Advantage |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.26
|
| Rate for Payer: Cigna Commercial |
$31.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.29
|
| Rate for Payer: Oxford Commercial |
$31.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.88
|
|
|
TUBE CONNECTNG 14FR W/STOPCOCK
|
Facility
|
IP
|
$63.75
|
|
| Hospital Charge Code |
270623768
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$9.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.56
|
|
|
TUBE, CULTURE 13X 100MM
|
Facility
|
IP
|
$74.42
|
|
| Hospital Charge Code |
270654388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$11.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.16
|
|
|
TUBE, CULTURE 13X 100MM
|
Facility
|
OP
|
$74.42
|
|
| Hospital Charge Code |
270654388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$37.21 |
| Rate for Payer: Aetna Commercial |
$22.33
|
| Rate for Payer: Aetna Medicare Advantage |
$22.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.98
|
| Rate for Payer: Cigna Commercial |
$37.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.67
|
| Rate for Payer: Oxford Commercial |
$37.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.21
|
|
|
TUBE DOBBHOFF
|
Facility
|
IP
|
$56.88
|
|
| Hospital Charge Code |
270302285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$8.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.53
|
|
|
TUBE DOBBHOFF
|
Facility
|
OP
|
$56.88
|
|
| Hospital Charge Code |
270302285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna Commercial |
$17.06
|
| Rate for Payer: Aetna Medicare Advantage |
$17.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.50
|
| Rate for Payer: Cigna Commercial |
$28.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.39
|
| Rate for Payer: Oxford Commercial |
$28.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$28.44
|
|
|
TUBE DOBHOFF*****
|
Facility
|
OP
|
$81.00
|
|
| Hospital Charge Code |
8000770
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$10.53 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$24.30
|
| Rate for Payer: Aetna Medicare Advantage |
$24.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.66
|
| Rate for Payer: Cigna Commercial |
$40.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.53
|
| Rate for Payer: Oxford Commercial |
$40.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.50
|
|
|
TUBE DOBHOFF*****
|
Facility
|
IP
|
$81.00
|
|
| Hospital Charge Code |
8000770
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$12.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.15
|
|
|
TUBE DRAIN BLAKE SI HBLS
|
Facility
|
IP
|
$274.66
|
|
| Hospital Charge Code |
270689560
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.20
|
|
|
TUBE DRAIN BLAKE SI HBLS
|
Facility
|
OP
|
$274.66
|
|
| Hospital Charge Code |
270689560
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.71 |
| Max. Negotiated Rate |
$137.33 |
| Rate for Payer: Aetna Commercial |
$82.40
|
| Rate for Payer: Aetna Medicare Advantage |
$82.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.04
|
| Rate for Payer: Cigna Commercial |
$137.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: Oxford Commercial |
$137.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.33
|
|
|
TUBE ELECTROSURG COAG SUCT****
|
Facility
|
IP
|
$35.00
|
|
| Hospital Charge Code |
1600683
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.25
|
|
|
TUBE ELECTROSURG COAG SUCT****
|
Facility
|
OP
|
$35.00
|
|
| Hospital Charge Code |
1600683
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Aetna Commercial |
$10.50
|
| Rate for Payer: Aetna Medicare Advantage |
$10.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.93
|
| Rate for Payer: Cigna Commercial |
$17.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.55
|
| Rate for Payer: Oxford Commercial |
$17.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.50
|
|
|
TUBE ELECTROSURG COAGUL 809600
|
Facility
|
OP
|
$77.65
|
|
| Hospital Charge Code |
270061405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$38.83 |
| Rate for Payer: Aetna Commercial |
$23.30
|
| Rate for Payer: Aetna Medicare Advantage |
$23.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.80
|
| Rate for Payer: Cigna Commercial |
$38.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.09
|
| Rate for Payer: Oxford Commercial |
$38.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.83
|
|
|
TUBE ELECTROSURG COAGUL 809600
|
Facility
|
IP
|
$77.65
|
|
| Hospital Charge Code |
270061405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$11.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.65
|
|
|
TUBE ENDOBRONCHIAL 41FR
|
Facility
|
OP
|
$268.33
|
|
| Hospital Charge Code |
270660609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$134.16 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Medicare Advantage |
$80.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.42
|
| Rate for Payer: Cigna Commercial |
$134.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.88
|
| Rate for Payer: Oxford Commercial |
$134.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$134.16
|
|