|
TUBING T-U-R TYPE SET
|
Facility
|
OP
|
$34.60
|
|
| Hospital Charge Code |
270650117
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$17.30 |
| Rate for Payer: Aetna Commercial |
$10.38
|
| Rate for Payer: Aetna Medicare Advantage |
$10.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.82
|
| Rate for Payer: Cigna Commercial |
$17.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.50
|
| Rate for Payer: Oxford Commercial |
$17.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.30
|
|
|
TUBING T.U.R. Y-TYPE SET
|
Facility
|
OP
|
$34.60
|
|
| Hospital Charge Code |
270649238
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$17.30 |
| Rate for Payer: Aetna Commercial |
$10.38
|
| Rate for Payer: Aetna Medicare Advantage |
$10.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.82
|
| Rate for Payer: Cigna Commercial |
$17.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.50
|
| Rate for Payer: Oxford Commercial |
$17.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.30
|
|
|
TUBING T.U.R. Y-TYPE SET
|
Facility
|
IP
|
$34.60
|
|
| Hospital Charge Code |
270649238
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.19 |
| Max. Negotiated Rate |
$5.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.19
|
|
|
TUBING UTERINE ASPIR 40789-002
|
Facility
|
IP
|
$37.00
|
|
| Hospital Charge Code |
270600271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$5.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.55
|
|
|
TUBING UTERINE ASPIR 40789-002
|
Facility
|
OP
|
$37.00
|
|
| Hospital Charge Code |
270600271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$18.50 |
| Rate for Payer: Aetna Commercial |
$11.10
|
| Rate for Payer: Aetna Medicare Advantage |
$11.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.44
|
| Rate for Payer: Cigna Commercial |
$18.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.81
|
| Rate for Payer: Oxford Commercial |
$18.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.50
|
|
|
TUBING VERSICON PUMP DISPOS
|
Facility
|
IP
|
$420.00
|
|
| Hospital Charge Code |
270674010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
|
|
TUBING VERSICON PUMP DISPOS
|
Facility
|
OP
|
$420.00
|
|
| Hospital Charge Code |
270674010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$126.00
|
| Rate for Payer: Aetna Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$107.10
|
| Rate for Payer: Cigna Commercial |
$210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.60
|
| Rate for Payer: Oxford Commercial |
$210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$210.00
|
|
|
TUBING WITH SPONGE GUARD 7/8IN
|
Facility
|
OP
|
$65.91
|
|
| Hospital Charge Code |
270677063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$32.95 |
| Rate for Payer: Aetna Commercial |
$19.77
|
| Rate for Payer: Aetna Medicare Advantage |
$19.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.81
|
| Rate for Payer: Cigna Commercial |
$32.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.57
|
| Rate for Payer: Oxford Commercial |
$32.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.95
|
|
|
TUBING WITH SPONGE GUARD 7/8IN
|
Facility
|
IP
|
$65.91
|
|
| Hospital Charge Code |
270677063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.89 |
| Max. Negotiated Rate |
$9.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.89
|
|
|
TUBING Y-FILL QUIK TO QUIK
|
Facility
|
OP
|
$185.25
|
|
| Hospital Charge Code |
270676434
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.08 |
| Max. Negotiated Rate |
$92.62 |
| Rate for Payer: Aetna Commercial |
$55.58
|
| Rate for Payer: Aetna Medicare Advantage |
$55.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.24
|
| Rate for Payer: Cigna Commercial |
$92.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.08
|
| Rate for Payer: Oxford Commercial |
$92.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$92.62
|
|
|
TUBING Y-FILL QUIK TO QUIK
|
Facility
|
IP
|
$185.25
|
|
| Hospital Charge Code |
270676434
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.79 |
| Max. Negotiated Rate |
$27.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.79
|
|
|
TUBING Y-SITE EXT*****
|
Facility
|
IP
|
$9.00
|
|
| Hospital Charge Code |
7000466
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.35
|
|
|
TUBING Y-SITE EXT*****
|
Facility
|
OP
|
$9.00
|
|
| Hospital Charge Code |
7000466
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna Commercial |
$2.70
|
| Rate for Payer: Aetna Medicare Advantage |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.29
|
| Rate for Payer: Cigna Commercial |
$4.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.17
|
| Rate for Payer: Oxford Commercial |
$4.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.50
|
|
|
TUBING Y TYPE BLD ADMNV2500***
|
Facility
|
IP
|
$8.00
|
|
| Hospital Charge Code |
7000839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$1.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.20
|
|
|
TUBING Y TYPE BLD ADMNV2500***
|
Facility
|
OP
|
$8.00
|
|
| Hospital Charge Code |
7000839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$2.40
|
| Rate for Payer: Aetna Medicare Advantage |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.04
|
| Rate for Payer: Cigna Commercial |
$4.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.04
|
| Rate for Payer: Oxford Commercial |
$4.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.00
|
|
|
TUBING Y TYPE TUR IR OR
|
Facility
|
IP
|
$43.25
|
|
| Hospital Charge Code |
270040330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$6.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.49
|
|
|
TUBING Y TYPE TUR IR OR
|
Facility
|
OP
|
$43.25
|
|
| Hospital Charge Code |
270040330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$21.62 |
| Rate for Payer: Aetna Commercial |
$12.97
|
| Rate for Payer: Aetna Medicare Advantage |
$12.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.03
|
| Rate for Payer: Cigna Commercial |
$21.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.62
|
| Rate for Payer: Oxford Commercial |
$21.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.62
|
|
|
TUBOCURARINE CHLORIDE/3MG
|
Facility
|
OP
|
$61.00
|
|
| Hospital Charge Code |
60634096
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$30.50 |
| Rate for Payer: Aetna Commercial |
$18.30
|
| Rate for Payer: Aetna Medicare Advantage |
$18.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.55
|
| Rate for Payer: Cigna Commercial |
$30.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.93
|
| Rate for Payer: Oxford Commercial |
$30.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.50
|
|
|
TUBOCURARINE CHLORIDE/3MG
|
Facility
|
IP
|
$61.00
|
|
| Hospital Charge Code |
60634096
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.15 |
| Max. Negotiated Rate |
$9.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.15
|
|
|
TUBOCURARINE INJ 3MG/ML 10ML
|
Facility
|
OP
|
$74.90
|
|
| Hospital Charge Code |
6005573
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.74 |
| Max. Negotiated Rate |
$37.45 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: Aetna Medicare Advantage |
$22.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.10
|
| Rate for Payer: Cigna Commercial |
$37.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.74
|
| Rate for Payer: Oxford Commercial |
$37.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.45
|
|
|
TUBOCURARINE INJ 3MG/ML 10ML
|
Facility
|
IP
|
$74.90
|
|
| Hospital Charge Code |
6005573
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.23
|
|
|
TUCKS
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 30014010299
|
| Hospital Charge Code |
6063943260
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
TUCKS
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 30014010299
|
| Hospital Charge Code |
6063943260
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
TUCKS *******
|
Facility
|
OP
|
$44.00
|
|
| Hospital Charge Code |
8001786
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$22.00 |
| Rate for Payer: Aetna Commercial |
$13.20
|
| Rate for Payer: Aetna Medicare Advantage |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.22
|
| Rate for Payer: Cigna Commercial |
$22.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.72
|
| Rate for Payer: Oxford Commercial |
$22.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.00
|
|
|
TUCKS *******
|
Facility
|
IP
|
$44.00
|
|
| Hospital Charge Code |
8001786
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$6.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
|