|
CANNULA PASSPORT BUTTON 40 MM
|
Facility
|
IP
|
$300.00
|
|
| Hospital Charge Code |
270688470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
CANNULA PASSPORT BUTTON 40 MM
|
Facility
|
OP
|
$300.00
|
|
| Hospital Charge Code |
270688470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.50
|
| Rate for Payer: Cigna Commercial |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.00
|
| Rate for Payer: Oxford Commercial |
$150.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$150.00
|
|
|
CANNULA PASSPORT BUTTON 8X3CM
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
270664263
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.00
|
|
|
CANNULA PASSPORT BUTTON 8X3CM
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
270664263
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$48.00
|
| Rate for Payer: Aetna Medicare Advantage |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.80
|
| Rate for Payer: Cigna Commercial |
$80.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.80
|
| Rate for Payer: Oxford Commercial |
$80.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.00
|
|
|
CANNULA PCL
|
Facility
|
OP
|
$380.00
|
|
| Hospital Charge Code |
270666964
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$114.00
|
| Rate for Payer: Aetna Medicare Advantage |
$114.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$96.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$96.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$96.90
|
| Rate for Payer: Cigna Commercial |
$190.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.40
|
| Rate for Payer: Oxford Commercial |
$190.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.00
|
|
|
CANNULA PCL
|
Facility
|
IP
|
$380.00
|
|
| Hospital Charge Code |
270666964
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.00 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.00
|
|
|
CANNULA PROSOFT ADULT
|
Facility
|
OP
|
$67.50
|
|
| Hospital Charge Code |
270689828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$20.25
|
| Rate for Payer: Aetna Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.21
|
| Rate for Payer: Cigna Commercial |
$33.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.78
|
| Rate for Payer: Oxford Commercial |
$33.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.75
|
|
|
CANNULA PROSOFT ADULT
|
Facility
|
IP
|
$67.50
|
|
| Hospital Charge Code |
270689828
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$10.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
|
|
CANNULA PROSOFT INFANT
|
Facility
|
OP
|
$67.50
|
|
| Hospital Charge Code |
270689831
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$20.25
|
| Rate for Payer: Aetna Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.21
|
| Rate for Payer: Cigna Commercial |
$33.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.78
|
| Rate for Payer: Oxford Commercial |
$33.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.75
|
|
|
CANNULA PROSOFT INFANT
|
Facility
|
IP
|
$67.50
|
|
| Hospital Charge Code |
270689831
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$10.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
|
|
CANNULA PROSOFT NEONATE
|
Facility
|
OP
|
$67.50
|
|
| Hospital Charge Code |
270689832
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$20.25
|
| Rate for Payer: Aetna Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.21
|
| Rate for Payer: Cigna Commercial |
$33.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.78
|
| Rate for Payer: Oxford Commercial |
$33.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.75
|
|
|
CANNULA PROSOFT NEONATE
|
Facility
|
IP
|
$67.50
|
|
| Hospital Charge Code |
270689832
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$10.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
|
|
CANNULA PROSOFT PEDS/ADULT SML
|
Facility
|
IP
|
$67.50
|
|
| Hospital Charge Code |
270689829
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$10.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
|
|
CANNULA PROSOFT PEDS/ADULT SML
|
Facility
|
OP
|
$67.50
|
|
| Hospital Charge Code |
270689829
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$20.25
|
| Rate for Payer: Aetna Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.21
|
| Rate for Payer: Cigna Commercial |
$33.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.78
|
| Rate for Payer: Oxford Commercial |
$33.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.75
|
|
|
CANNULA PROSOFT-XL
|
Facility
|
OP
|
$67.50
|
|
| Hospital Charge Code |
270689830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$20.25
|
| Rate for Payer: Aetna Medicare Advantage |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.21
|
| Rate for Payer: Cigna Commercial |
$33.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.78
|
| Rate for Payer: Oxford Commercial |
$33.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.75
|
|
|
CANNULA PROSOFT-XL
|
Facility
|
IP
|
$67.50
|
|
| Hospital Charge Code |
270689830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$10.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.12
|
|
|
CANNULA P/THD 7MMX11CM
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
270675728
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$3.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.86
|
|
|
CANNULA P/THD 7MMX11CM
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
270675728
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$12.88 |
| Rate for Payer: Aetna Commercial |
$7.72
|
| Rate for Payer: Aetna Medicare Advantage |
$7.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.57
|
| Rate for Payer: Cigna Commercial |
$12.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.35
|
| Rate for Payer: Oxford Commercial |
$12.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.88
|
|
|
CANNULA RESPIRONICS CO2/02
|
Facility
|
IP
|
$127.70
|
|
| Hospital Charge Code |
270704860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$19.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.16
|
|
|
CANNULA RESPIRONICS CO2/02
|
Facility
|
OP
|
$127.70
|
|
| Hospital Charge Code |
270704860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.60 |
| Max. Negotiated Rate |
$63.85 |
| Rate for Payer: Aetna Commercial |
$38.31
|
| Rate for Payer: Aetna Medicare Advantage |
$38.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.56
|
| Rate for Payer: Cigna Commercial |
$63.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.60
|
| Rate for Payer: Oxford Commercial |
$63.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.85
|
|
|
CANNULA RF 10cM 20ga 7210275
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
270639098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.75 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna Commercial |
$52.50
|
| Rate for Payer: Aetna Medicare Advantage |
$52.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.62
|
| Rate for Payer: Cigna Commercial |
$87.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.75
|
| Rate for Payer: Oxford Commercial |
$87.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$87.50
|
|
|
CANNULA RF 10cM 20ga 7210275
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
270639098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
CANNULA RF 22G 100x5mm CRVD
|
Facility
|
IP
|
$357.50
|
|
| Hospital Charge Code |
270671754
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$53.62 |
| Max. Negotiated Rate |
$53.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
|
|
CANNULA RF 22G 100x5mm CRVD
|
Facility
|
OP
|
$357.50
|
|
| Hospital Charge Code |
270671754
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$46.48 |
| Max. Negotiated Rate |
$178.75 |
| Rate for Payer: Aetna Commercial |
$107.25
|
| Rate for Payer: Aetna Medicare Advantage |
$107.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.16
|
| Rate for Payer: Cigna Commercial |
$178.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.48
|
| Rate for Payer: Oxford Commercial |
$178.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$178.75
|
|
|
CANNULA RF NEEDLE 100MM 22G
|
Facility
|
IP
|
$205.75
|
|
| Hospital Charge Code |
270654885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.86 |
| Max. Negotiated Rate |
$30.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.86
|
|