|
ZEBETA 5MG TAB
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60635123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.91
|
| Rate for Payer: Oxford Commercial |
$3.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.50
|
|
|
ZEBETA 5MG TAB
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60635123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
ZELNORM 6MG TAB
|
Facility
|
IP
|
$11.00
|
|
| Hospital Charge Code |
60635512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$1.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.65
|
|
|
ZELNORM 6MG TAB
|
Facility
|
OP
|
$11.00
|
|
| Hospital Charge Code |
60635512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$5.50 |
| Rate for Payer: Aetna Commercial |
$3.30
|
| Rate for Payer: Aetna Medicare Advantage |
$3.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.81
|
| Rate for Payer: Cigna Commercial |
$5.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.43
|
| Rate for Payer: Oxford Commercial |
$5.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.50
|
|
|
ZEMURON
|
Facility
|
IP
|
$47.35
|
|
| Hospital Charge Code |
270656767
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$7.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.10
|
|
|
ZEMURON
|
Facility
|
OP
|
$47.35
|
|
| Hospital Charge Code |
270656767
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$23.68 |
| Rate for Payer: Aetna Commercial |
$14.21
|
| Rate for Payer: Aetna Medicare Advantage |
$14.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.07
|
| Rate for Payer: Cigna Commercial |
$23.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.16
|
| Rate for Payer: Oxford Commercial |
$23.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.68
|
|
|
ZEMURON INJ 10MG
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
60635147
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.70
|
| Rate for Payer: Oxford Commercial |
$95.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$95.00
|
|
|
ZEMURON INJ 10MG
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
60635147
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
ZEMURON INJECTION
|
Facility
|
OP
|
$107.00
|
|
| Hospital Charge Code |
60634996
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.91 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Aetna Commercial |
$32.10
|
| Rate for Payer: Aetna Medicare Advantage |
$32.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.29
|
| Rate for Payer: Cigna Commercial |
$53.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.91
|
| Rate for Payer: Oxford Commercial |
$53.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$53.50
|
|
|
ZEMURON INJECTION
|
Facility
|
IP
|
$107.00
|
|
| Hospital Charge Code |
60634996
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.05 |
| Max. Negotiated Rate |
$16.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
|
|
ZENITH AAA MAIN BDY TFB-32-103
|
Facility
|
OP
|
$36,704.00
|
|
| Hospital Charge Code |
270636634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,505.60 |
| Max. Negotiated Rate |
$18,352.00 |
| Rate for Payer: Aetna Commercial |
$11,011.20
|
| Rate for Payer: Aetna Medicare Advantage |
$11,011.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,359.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,359.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,340.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,359.52
|
| Rate for Payer: Cigna Commercial |
$18,352.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,882.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,505.60
|
|
|
ZENITH AAA MAIN BDY TFB-32-103
|
Facility
|
OP
|
$37,000.00
|
|
| Hospital Charge Code |
270636634V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,550.00 |
| Max. Negotiated Rate |
$18,500.00 |
| Rate for Payer: Aetna Commercial |
$11,100.00
|
| Rate for Payer: Aetna Medicare Advantage |
$11,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,400.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,435.00
|
| Rate for Payer: Cigna Commercial |
$18,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,954.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,550.00
|
|
|
ZENITH AAA MAIN BDY TFB-32-103
|
Facility
|
IP
|
$36,704.00
|
|
| Hospital Charge Code |
270636634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,505.60 |
| Max. Negotiated Rate |
$8,882.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,340.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,882.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,505.60
|
|
|
ZENITH AAA MAIN BDY TFB-32-103
|
Facility
|
IP
|
$37,000.00
|
|
| Hospital Charge Code |
270636634V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,550.00 |
| Max. Negotiated Rate |
$8,954.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,954.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,550.00
|
|
|
ZENITH FLEX AAA GRAFT TFFB2482
|
Facility
|
IP
|
$41,060.00
|
|
| Hospital Charge Code |
270638578V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,159.00 |
| Max. Negotiated Rate |
$9,936.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8,212.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,936.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,159.00
|
|
|
ZENITH FLEX AAA GRAFT TFFB2482
|
Facility
|
OP
|
$41,060.00
|
|
| Hospital Charge Code |
270638578V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,159.00 |
| Max. Negotiated Rate |
$20,530.00 |
| Rate for Payer: Aetna Commercial |
$12,318.00
|
| Rate for Payer: Aetna Medicare Advantage |
$12,318.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,470.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,470.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8,212.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10,470.30
|
| Rate for Payer: Cigna Commercial |
$20,530.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,936.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,159.00
|
|
|
ZEPHER RADIAL BAND
|
Facility
|
OP
|
$901.25
|
|
| Hospital Charge Code |
270699036
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$117.16 |
| Max. Negotiated Rate |
$450.62 |
| Rate for Payer: Aetna Commercial |
$270.38
|
| Rate for Payer: Aetna Medicare Advantage |
$270.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$229.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$229.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$229.82
|
| Rate for Payer: Cigna Commercial |
$450.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.16
|
| Rate for Payer: Oxford Commercial |
$450.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$450.62
|
|
|
ZEPHER RADIAL BAND
|
Facility
|
IP
|
$901.25
|
|
| Hospital Charge Code |
270699036
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$135.19 |
| Max. Negotiated Rate |
$135.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.19
|
|
|
ZERIT/15MG/CAP
|
Facility
|
IP
|
$54.87
|
|
|
Service Code
|
NDC 3196401
|
| Hospital Charge Code |
60634955
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$8.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.23
|
|
|
ZERIT/15MG/CAP
|
Facility
|
OP
|
$54.87
|
|
|
Service Code
|
NDC 3196401
|
| Hospital Charge Code |
60634955
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$27.43 |
| Rate for Payer: Aetna Commercial |
$16.46
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.99
|
| Rate for Payer: Cigna Commercial |
$27.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.13
|
| Rate for Payer: Oxford Commercial |
$27.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.43
|
|
|
ZERO-P VA CAGE 6MM LORDOTIC
|
Facility
|
OP
|
$16,267.25
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270670528
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,440.09 |
| Max. Negotiated Rate |
$8,133.62 |
| Rate for Payer: Aetna Commercial |
$4,880.18
|
| Rate for Payer: Aetna Medicare Advantage |
$4,880.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,148.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,148.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,253.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,148.15
|
| Rate for Payer: Cigna Commercial |
$8,133.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,936.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,440.09
|
|
|
ZERO-P VA CAGE 6MM LORDOTIC
|
Facility
|
IP
|
$16,267.25
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270670528
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,440.09 |
| Max. Negotiated Rate |
$3,936.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,253.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,936.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,440.09
|
|
|
ZESTRIL/10MG/TAB
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60634197
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
ZESTRIL/10MG/TAB
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60634197
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.91
|
| Rate for Payer: Oxford Commercial |
$3.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.50
|
|
|
ZESTRIL/10MG/TAB
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60634198
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|