|
ACCOLADE MRI DR
|
Facility
|
OP
|
$51,500.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
270686184S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,725.00 |
| Max. Negotiated Rate |
$25,750.00 |
| Rate for Payer: Aetna Commercial |
$15,450.00
|
| Rate for Payer: Aetna Medicare Advantage |
$15,450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,132.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,132.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10,300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,132.50
|
| Rate for Payer: Cigna Commercial |
$25,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12,463.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,725.00
|
|
|
ACCOLADE MRI DR
|
Facility
|
IP
|
$51,500.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
270686184S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,725.00 |
| Max. Negotiated Rate |
$12,463.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10,300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12,463.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,725.00
|
|
|
ACCOLATE 20MG TAB UD
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60635153
|
|
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
|
|
|
ACCOLATE 20MG TAB UD
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60635153
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
ACCUCHEK.GLUCOSE
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
38479001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
ACCUCHEK.GLUCOSE
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
38479001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$12.73
|
| Rate for Payer: Aetna Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.40
|
| Rate for Payer: Cigna Commercial |
$3.93
|
| Rate for Payer: Cigna Medicare Advantage |
$1.97
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.28
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$4.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
|
|
ACCUFILL
|
Facility
|
OP
|
$17,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,550.00 |
| Max. Negotiated Rate |
$8,500.00 |
| Rate for Payer: Aetna Commercial |
$5,100.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,335.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,335.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,400.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,335.00
|
| Rate for Payer: Cigna Commercial |
$8,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,114.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,550.00
|
|
|
ACCUFILL
|
Facility
|
IP
|
$17,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,550.00 |
| Max. Negotiated Rate |
$4,114.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,114.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,550.00
|
|
|
ACCUFILL PF BSM 3CC
|
Facility
|
IP
|
$11,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,687.50 |
| Max. Negotiated Rate |
$2,722.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,722.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,687.50
|
|
|
ACCUFILL PF BSM 3CC
|
Facility
|
OP
|
$16,650.00
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
270704260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,497.50 |
| Max. Negotiated Rate |
$8,325.00 |
| Rate for Payer: Aetna Commercial |
$4,995.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,245.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,245.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,330.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,245.75
|
| Rate for Payer: Cigna Commercial |
$8,325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,029.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,497.50
|
|
|
ACCUFILL PF BSM 3CC
|
Facility
|
IP
|
$16,650.00
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
270704260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,497.50 |
| Max. Negotiated Rate |
$4,029.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,029.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,497.50
|
|
|
ACCUFILL PF BSM 3CC
|
Facility
|
OP
|
$11,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,687.50 |
| Max. Negotiated Rate |
$5,625.00 |
| Rate for Payer: Aetna Commercial |
$3,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,868.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,868.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,868.75
|
| Rate for Payer: Cigna Commercial |
$5,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,722.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,687.50
|
|
|
ACCUNEB INH 1.25MG
|
Facility
|
IP
|
$6.00
|
|
| Hospital Charge Code |
60635530
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
ACCUNEB INH 1.25MG
|
Facility
|
OP
|
$6.00
|
|
| Hospital Charge Code |
60635530
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.53
|
| Rate for Payer: Cigna Commercial |
$3.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.78
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
|
|
ACCU-PASS DIRECT CRESENT XL
|
Facility
|
OP
|
$5,025.00
|
|
| Hospital Charge Code |
270682257
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$653.25 |
| Max. Negotiated Rate |
$2,512.50 |
| Rate for Payer: Aetna Commercial |
$1,507.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,507.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,281.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,281.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,281.38
|
| Rate for Payer: Cigna Commercial |
$2,512.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$653.25
|
| Rate for Payer: Oxford Commercial |
$2,512.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$753.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,512.50
|
|
|
ACCU-PASS DIRECT CRESENT XL
|
Facility
|
IP
|
$5,025.00
|
|
| Hospital Charge Code |
270682257
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$753.75 |
| Max. Negotiated Rate |
$753.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$753.75
|
|
|
ACCU-PASS STR SHUTTLE 45 DEG U
|
Facility
|
IP
|
$655.20
|
|
| Hospital Charge Code |
270682256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.28 |
| Max. Negotiated Rate |
$98.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$98.28
|
|
|
ACCU-PASS STR SHUTTLE 45 DEG U
|
Facility
|
OP
|
$655.20
|
|
| Hospital Charge Code |
270682256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.18 |
| Max. Negotiated Rate |
$327.60 |
| Rate for Payer: Aetna Commercial |
$196.56
|
| Rate for Payer: Aetna Medicare Advantage |
$196.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$167.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$167.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$167.08
|
| Rate for Payer: Cigna Commercial |
$327.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.18
|
| Rate for Payer: Oxford Commercial |
$327.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$98.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$327.60
|
|
|
ACCU-PASS STR SHUTTLE STRAIGHT
|
Facility
|
OP
|
$666.75
|
|
| Hospital Charge Code |
270673677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$333.38 |
| Rate for Payer: Aetna Commercial |
$200.03
|
| Rate for Payer: Aetna Medicare Advantage |
$200.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.02
|
| Rate for Payer: Cigna Commercial |
$333.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.68
|
| Rate for Payer: Oxford Commercial |
$333.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$333.38
|
|
|
ACCU-PASS STR SHUTTLE STRAIGHT
|
Facility
|
IP
|
$666.75
|
|
| Hospital Charge Code |
270673677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.01 |
| Max. Negotiated Rate |
$100.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.01
|
|
|
ACCURTHERM
|
Facility
|
IP
|
$10,500.00
|
|
| Hospital Charge Code |
270657279
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$2,541.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,541.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,575.00
|
|
|
ACCURTHERM
|
Facility
|
OP
|
$10,500.00
|
|
| Hospital Charge Code |
270657279
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$5,250.00 |
| Rate for Payer: Aetna Commercial |
$3,150.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,677.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,677.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,677.50
|
| Rate for Payer: Cigna Commercial |
$5,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,541.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,575.00
|
|
|
ACCURUS TOTAL PLUS PACK
|
Facility
|
IP
|
$643.00
|
|
| Hospital Charge Code |
270335691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.45 |
| Max. Negotiated Rate |
$96.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.45
|
|
|
ACCURUS TOTAL PLUS PACK
|
Facility
|
OP
|
$643.00
|
|
| Hospital Charge Code |
270335691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.59 |
| Max. Negotiated Rate |
$321.50 |
| Rate for Payer: Aetna Commercial |
$192.90
|
| Rate for Payer: Aetna Medicare Advantage |
$192.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$163.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$163.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$163.97
|
| Rate for Payer: Cigna Commercial |
$321.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$83.59
|
| Rate for Payer: Oxford Commercial |
$321.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$321.50
|
|
|
ACCUSTICK II INTRODUCER SYSTEM
|
Facility
|
OP
|
$336.70
|
|
| Hospital Charge Code |
2709001642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Aetna Commercial |
$101.01
|
| Rate for Payer: Aetna Medicare Advantage |
$101.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$85.86
|
| Rate for Payer: Cigna Commercial |
$168.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.77
|
| Rate for Payer: Oxford Commercial |
$168.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$168.35
|
|