|
CATHETER LOCKING DRAINAGE 12FR
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270655075R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
CATHETER LOCKING DRAINAGE 12FR
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270655075S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
CATHETER LOCKING DRAINAGE 12FR
|
Facility
|
OP
|
$328.00
|
|
| Hospital Charge Code |
270655075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$164.00 |
| Rate for Payer: Aetna Commercial |
$98.40
|
| Rate for Payer: Aetna Medicare Advantage |
$98.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.64
|
| Rate for Payer: Cigna Commercial |
$164.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$164.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$164.00
|
|
|
CATHETER LOCKING DRAINAGE 12FR
|
Facility
|
IP
|
$346.75
|
|
| Hospital Charge Code |
270655075N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.01 |
| Max. Negotiated Rate |
$52.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.01
|
|
|
CATHETER LOW-PROFILE 6MM X 6CM
|
Facility
|
OP
|
$1,200.00
|
|
| Hospital Charge Code |
270667763
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Aetna Commercial |
$360.00
|
| Rate for Payer: Aetna Medicare Advantage |
$360.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$306.00
|
| Rate for Payer: Cigna Commercial |
$600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$156.00
|
| Rate for Payer: Oxford Commercial |
$600.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$600.00
|
|
|
CATHETER LOW-PROFILE 6MM X 6CM
|
Facility
|
IP
|
$1,200.00
|
|
| Hospital Charge Code |
270667763
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
|
|
CATHETER LP PTA 4.0FR 4CM
|
Facility
|
OP
|
$2,650.00
|
|
| Hospital Charge Code |
270668377
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$397.50 |
| Max. Negotiated Rate |
$1,325.00 |
| Rate for Payer: Aetna Commercial |
$795.00
|
| Rate for Payer: Aetna Medicare Advantage |
$795.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$675.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$675.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$675.75
|
| Rate for Payer: Cigna Commercial |
$1,325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$641.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$397.50
|
|
|
CATHETER LP PTA 4.0FR 4CM
|
Facility
|
IP
|
$2,650.00
|
|
| Hospital Charge Code |
270668377
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$397.50 |
| Max. Negotiated Rate |
$641.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$641.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$397.50
|
|
|
CATHETER MAHURKA
|
Facility
|
OP
|
$514.11
|
|
| Hospital Charge Code |
270655948
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.83 |
| Max. Negotiated Rate |
$257.06 |
| Rate for Payer: Aetna Commercial |
$154.23
|
| Rate for Payer: Aetna Medicare Advantage |
$154.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$131.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$131.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$131.10
|
| Rate for Payer: Cigna Commercial |
$257.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.83
|
| Rate for Payer: Oxford Commercial |
$257.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$257.06
|
|
|
CATHETER MAHURKA
|
Facility
|
IP
|
$514.11
|
|
| Hospital Charge Code |
270655948
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.12 |
| Max. Negotiated Rate |
$77.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.12
|
|
|
CATHETER MALECOT URET. 18FR
|
Facility
|
OP
|
$65.00
|
|
| Hospital Charge Code |
270331471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.57
|
| Rate for Payer: Cigna Commercial |
$32.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
CATHETER MALECOT URET. 18FR
|
Facility
|
IP
|
$65.00
|
|
| Hospital Charge Code |
270331471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$15.73 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
CATHETER MANI 5FR
|
Facility
|
OP
|
$327.55
|
|
| Hospital Charge Code |
270651792
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.58 |
| Max. Negotiated Rate |
$163.78 |
| Rate for Payer: Aetna Commercial |
$98.27
|
| Rate for Payer: Aetna Medicare Advantage |
$98.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$83.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$83.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$83.53
|
| Rate for Payer: Cigna Commercial |
$163.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.58
|
| Rate for Payer: Oxford Commercial |
$163.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$163.78
|
|
|
CATHETER MANI 5FR
|
Facility
|
IP
|
$327.55
|
|
| Hospital Charge Code |
270651792
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.13 |
| Max. Negotiated Rate |
$49.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.13
|
|
|
CATHETER MANI 5FR 100 x .035
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270665046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER MANI 5FR 100 x .035
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270665046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$18.00
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER MARATHON NO STYLET
|
Facility
|
IP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$1,089.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
CATHETER MARATHON NO STYLET
|
Facility
|
OP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,147.50
|
| Rate for Payer: Cigna Commercial |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
CATHETER MARATHON NO STYLET
|
Facility
|
OP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685190S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,147.50
|
| Rate for Payer: Cigna Commercial |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
CATHETER MARATHON NO STYLET
|
Facility
|
IP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685190S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$1,089.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
CATHETER MARKSMAN 150 CM
|
Facility
|
OP
|
$6,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Aetna Commercial |
$1,950.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,950.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,657.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,657.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,657.50
|
| Rate for Payer: Cigna Commercial |
$3,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,573.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$975.00
|
|
|
CATHETER MARKSMAN 150 CM
|
Facility
|
OP
|
$6,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685147S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Aetna Commercial |
$1,950.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,950.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,657.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,657.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,657.50
|
| Rate for Payer: Cigna Commercial |
$3,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,573.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$975.00
|
|
|
CATHETER MARKSMAN 150 CM
|
Facility
|
IP
|
$6,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685147S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$1,573.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,573.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$975.00
|
|
|
CATHETER MARKSMAN 150 CM
|
Facility
|
IP
|
$6,500.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$1,573.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,573.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$975.00
|
|
|
CATHETER MARKSMAN 160 CM
|
Facility
|
OP
|
$6,650.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270685146S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$997.50 |
| Max. Negotiated Rate |
$3,325.00 |
| Rate for Payer: Aetna Commercial |
$1,995.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,695.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,695.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,330.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,695.75
|
| Rate for Payer: Cigna Commercial |
$3,325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,609.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$997.50
|
|