|
TUBING PCA PUMP SET
|
Facility
|
IP
|
$10.68
|
|
| Hospital Charge Code |
270649228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.60
|
|
|
TUBING PCA PUMP SET
|
Facility
|
OP
|
$10.68
|
|
| Hospital Charge Code |
270649228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$5.34 |
| Rate for Payer: Aetna Commercial |
$3.20
|
| Rate for Payer: Aetna Medicare Advantage |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.72
|
| Rate for Payer: Cigna Commercial |
$5.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.39
|
| Rate for Payer: Oxford Commercial |
$5.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.34
|
|
|
TUBING PEND SUCTION PA2010
|
Facility
|
IP
|
$82.25
|
|
| Hospital Charge Code |
270638391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.34 |
| Max. Negotiated Rate |
$12.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.34
|
|
|
TUBING PEND SUCTION PA2010
|
Facility
|
OP
|
$82.25
|
|
| Hospital Charge Code |
270638391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Aetna Commercial |
$24.68
|
| Rate for Payer: Aetna Medicare Advantage |
$24.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.97
|
| Rate for Payer: Cigna Commercial |
$41.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.69
|
| Rate for Payer: Oxford Commercial |
$41.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$41.12
|
|
|
TUBING PLUM 4.0
|
Facility
|
OP
|
$103.50
|
|
| Hospital Charge Code |
270662866
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$31.05
|
| Rate for Payer: Aetna Medicare Advantage |
$31.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.39
|
| Rate for Payer: Cigna Commercial |
$51.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.46
|
| Rate for Payer: Oxford Commercial |
$51.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$51.75
|
|
|
TUBING PLUM 4.0
|
Facility
|
IP
|
$103.50
|
|
| Hospital Charge Code |
270662866
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.53 |
| Max. Negotiated Rate |
$15.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.53
|
|
|
TUBING PLUM BURRETTE MICRODRIP
|
Facility
|
IP
|
$69.83
|
|
| Hospital Charge Code |
270649483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$10.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.47
|
|
|
TUBING PLUM BURRETTE MICRODRIP
|
Facility
|
OP
|
$69.83
|
|
| Hospital Charge Code |
270649483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$34.91 |
| Rate for Payer: Aetna Commercial |
$20.95
|
| Rate for Payer: Aetna Medicare Advantage |
$20.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.81
|
| Rate for Payer: Cigna Commercial |
$34.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.08
|
| Rate for Payer: Oxford Commercial |
$34.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.91
|
|
|
TUBING PLUME AWAY 4.0MM
|
Facility
|
IP
|
$147.50
|
|
| Hospital Charge Code |
270683502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.12 |
| Max. Negotiated Rate |
$22.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.12
|
|
|
TUBING PLUME AWAY 4.0MM
|
Facility
|
OP
|
$147.50
|
|
| Hospital Charge Code |
270683502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$73.75 |
| Rate for Payer: Aetna Commercial |
$44.25
|
| Rate for Payer: Aetna Medicare Advantage |
$44.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.61
|
| Rate for Payer: Cigna Commercial |
$73.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.18
|
| Rate for Payer: Oxford Commercial |
$73.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$73.75
|
|
|
TUBING PLUM NITRO SET
|
Facility
|
OP
|
$28.75
|
|
| Hospital Charge Code |
270649229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$14.38 |
| Rate for Payer: Aetna Commercial |
$8.62
|
| Rate for Payer: Aetna Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.33
|
| Rate for Payer: Cigna Commercial |
$14.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.74
|
| Rate for Payer: Oxford Commercial |
$14.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.38
|
|
|
TUBING PLUM NITRO SET
|
Facility
|
IP
|
$28.75
|
|
| Hospital Charge Code |
270649229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$4.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.31
|
|
|
TUBING PRESSURE MONITOR 48
|
Facility
|
IP
|
$9.25
|
|
| Hospital Charge Code |
270653927
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.39
|
|
|
TUBING PRESSURE MONITOR 48
|
Facility
|
OP
|
$32.50
|
|
| Hospital Charge Code |
270653927N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna Commercial |
$9.75
|
| Rate for Payer: Aetna Medicare Advantage |
$9.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.29
|
| Rate for Payer: Cigna Commercial |
$16.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.22
|
| Rate for Payer: Oxford Commercial |
$16.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$16.25
|
|
|
TUBING PRESSURE MONITOR 48
|
Facility
|
IP
|
$32.50
|
|
| Hospital Charge Code |
270653927N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$4.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.88
|
|
|
TUBING PRESSURE MONITOR 48
|
Facility
|
OP
|
$9.25
|
|
| Hospital Charge Code |
270653927S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$4.62 |
| Rate for Payer: Aetna Commercial |
$2.77
|
| Rate for Payer: Aetna Medicare Advantage |
$2.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.36
|
| Rate for Payer: Cigna Commercial |
$4.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.20
|
| Rate for Payer: Oxford Commercial |
$4.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.62
|
|
|
TUBING PRESSURE MONITOR 48
|
Facility
|
OP
|
$9.25
|
|
| Hospital Charge Code |
270653927
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$4.62 |
| Rate for Payer: Aetna Commercial |
$2.77
|
| Rate for Payer: Aetna Medicare Advantage |
$2.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.36
|
| Rate for Payer: Cigna Commercial |
$4.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.20
|
| Rate for Payer: Oxford Commercial |
$4.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.62
|
|
|
TUBING PRESSURE MONITOR 48
|
Facility
|
IP
|
$9.25
|
|
| Hospital Charge Code |
270653927S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.39
|
|
|
TUBING PRESSURE TRANSMISSION
|
Facility
|
OP
|
$55.00
|
|
| Hospital Charge Code |
270650899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$27.50 |
| Rate for Payer: Aetna Commercial |
$16.50
|
| Rate for Payer: Aetna Medicare Advantage |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.03
|
| Rate for Payer: Cigna Commercial |
$27.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.15
|
| Rate for Payer: Oxford Commercial |
$27.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.50
|
|
|
TUBING PRESSURE TRANSMISSION
|
Facility
|
IP
|
$55.00
|
|
| Hospital Charge Code |
270650899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$8.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.25
|
|
|
TUBING PRIMARY CLAVE
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
270649230
|
|
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
|
|
|
TUBING PRIMARY CLAVE
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
270649230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
|
|
TUBING PRIMARY CLAVE SUB
|
Facility
|
OP
|
$23.05
|
|
| Hospital Charge Code |
270649231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$11.53 |
| Rate for Payer: Aetna Commercial |
$6.92
|
| Rate for Payer: Aetna Medicare Advantage |
$6.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.88
|
| Rate for Payer: Cigna Commercial |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.00
|
| Rate for Payer: Oxford Commercial |
$11.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.53
|
|
|
TUBING PRIMARY CLAVE SUB
|
Facility
|
IP
|
$23.05
|
|
| Hospital Charge Code |
270649231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.46
|
|
|
TUBING PRIMARY IV PIGGYBACK
|
Facility
|
IP
|
$19.83
|
|
| Hospital Charge Code |
270649977
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.97 |
| Max. Negotiated Rate |
$2.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.97
|
|