|
CATHETER PIG TAIL 5FR 65CM
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270669872
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Medicare Advantage |
$8.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.12
|
| Rate for Payer: Cigna Commercial |
$13.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.63
|
| Rate for Payer: Oxford Commercial |
$13.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.96
|
|
|
CATHETER PIGTAIL 7FR 527-750S
|
Facility
|
OP
|
$52.15
|
|
| Hospital Charge Code |
270612748
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.78 |
| Max. Negotiated Rate |
$26.07 |
| Rate for Payer: Aetna Commercial |
$15.64
|
| Rate for Payer: Aetna Medicare Advantage |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.30
|
| Rate for Payer: Cigna Commercial |
$26.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.78
|
| Rate for Payer: Oxford Commercial |
$26.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.07
|
|
|
CATHETER PIGTAIL 7FR 527-750S
|
Facility
|
IP
|
$52.15
|
|
| Hospital Charge Code |
270612748
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$7.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.82
|
|
|
CATHETER PIGTAIL 8FR NEPHRO
|
Facility
|
OP
|
$830.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270680006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$124.50 |
| Max. Negotiated Rate |
$415.00 |
| Rate for Payer: Aetna Commercial |
$249.00
|
| Rate for Payer: Aetna Medicare Advantage |
$249.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$211.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$211.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$166.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$211.65
|
| Rate for Payer: Cigna Commercial |
$415.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$200.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$124.50
|
|
|
CATHETER PIGTAIL 8FR NEPHRO
|
Facility
|
IP
|
$830.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270680006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$124.50 |
| Max. Negotiated Rate |
$200.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$166.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$200.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$124.50
|
|
|
CATHETER POWER PICC 135CM 5FR
|
Facility
|
OP
|
$635.00
|
|
| Hospital Charge Code |
270671561
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.25 |
| Max. Negotiated Rate |
$317.50 |
| Rate for Payer: Aetna Commercial |
$190.50
|
| Rate for Payer: Aetna Medicare Advantage |
$190.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$161.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$161.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$127.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$161.93
|
| Rate for Payer: Cigna Commercial |
$317.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$153.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.25
|
|
|
CATHETER POWER PICC 135CM 5FR
|
Facility
|
IP
|
$635.00
|
|
| Hospital Charge Code |
270671561
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.25 |
| Max. Negotiated Rate |
$153.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$127.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$153.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$95.25
|
|
|
CATHETER POWER PICC SOLO 5FR
|
Facility
|
OP
|
$1,391.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
270682901
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$208.65 |
| Max. Negotiated Rate |
$695.50 |
| Rate for Payer: Aetna Commercial |
$417.30
|
| Rate for Payer: Aetna Medicare Advantage |
$417.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$354.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$354.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$278.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$354.70
|
| Rate for Payer: Cigna Commercial |
$695.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$336.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$208.65
|
|
|
CATHETER POWER PICC SOLO 5FR
|
Facility
|
IP
|
$1,391.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
270682901
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$208.65 |
| Max. Negotiated Rate |
$336.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$278.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$336.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$208.65
|
|
|
CATHETER POWER PICC SOLO 5FR
|
Facility
|
IP
|
$4,173.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
270682901N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$625.95 |
| Max. Negotiated Rate |
$1,009.87 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$834.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,009.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$625.95
|
|
|
CATHETER POWER PICC SOLO 5FR
|
Facility
|
OP
|
$4,173.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
270682901N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$625.95 |
| Max. Negotiated Rate |
$2,086.50 |
| Rate for Payer: Aetna Commercial |
$1,251.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1,251.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,064.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,064.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$834.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,064.12
|
| Rate for Payer: Cigna Commercial |
$2,086.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,009.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$625.95
|
|
|
CATHETER PRECISE 5X30MM
|
Facility
|
OP
|
$10,565.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270696950S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,584.75 |
| Max. Negotiated Rate |
$5,282.50 |
| Rate for Payer: Aetna Commercial |
$3,169.50
|
| Rate for Payer: Aetna Medicare Advantage |
$3,169.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,694.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,694.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,113.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,694.07
|
| Rate for Payer: Cigna Commercial |
$5,282.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,556.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,584.75
|
|
|
CATHETER PRECISE 5X30MM
|
Facility
|
IP
|
$10,565.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270696950S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,584.75 |
| Max. Negotiated Rate |
$2,556.73 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,113.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,556.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,584.75
|
|
|
CATHETER PRECISE PRO 5X40MM
|
Facility
|
OP
|
$10,565.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270696951S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,584.75 |
| Max. Negotiated Rate |
$5,282.50 |
| Rate for Payer: Aetna Commercial |
$3,169.50
|
| Rate for Payer: Aetna Medicare Advantage |
$3,169.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,694.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,694.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,113.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,694.07
|
| Rate for Payer: Cigna Commercial |
$5,282.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,556.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,584.75
|
|
|
CATHETER PRECISE PRO 5X40MM
|
Facility
|
IP
|
$10,565.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270696951S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,584.75 |
| Max. Negotiated Rate |
$2,556.73 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,113.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,556.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,584.75
|
|
|
CATHETER PROGREAT 2.4X 130 MM
|
Facility
|
OP
|
$2,330.00
|
|
| Hospital Charge Code |
270696124
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$302.90 |
| Max. Negotiated Rate |
$1,165.00 |
| Rate for Payer: Aetna Commercial |
$699.00
|
| Rate for Payer: Aetna Medicare Advantage |
$699.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$594.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$594.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$594.15
|
| Rate for Payer: Cigna Commercial |
$1,165.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$302.90
|
| Rate for Payer: Oxford Commercial |
$1,165.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$349.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,165.00
|
|
|
CATHETER PROGREAT 2.4X 130 MM
|
Facility
|
IP
|
$2,330.00
|
|
| Hospital Charge Code |
270696124
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$349.50 |
| Max. Negotiated Rate |
$349.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$349.50
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
OP
|
$2,968.00
|
|
| Hospital Charge Code |
270658289N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$385.84 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Medicare Advantage |
$890.40
|
| Rate for Payer: Aetna Commercial |
$890.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$756.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$756.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$756.84
|
| Rate for Payer: Cigna Commercial |
$1,484.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.84
|
| Rate for Payer: Oxford Commercial |
$1,484.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$445.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,484.00
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
IP
|
$2,968.00
|
|
| Hospital Charge Code |
270658289O
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.20 |
| Max. Negotiated Rate |
$445.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$445.20
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
OP
|
$2,968.00
|
|
| Hospital Charge Code |
270658289O
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$385.84 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$890.40
|
| Rate for Payer: Aetna Medicare Advantage |
$890.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$756.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$756.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$756.84
|
| Rate for Payer: Cigna Commercial |
$1,484.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.84
|
| Rate for Payer: Oxford Commercial |
$1,484.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$445.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,484.00
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
IP
|
$2,800.00
|
|
| Hospital Charge Code |
270658289S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
IP
|
$3,485.00
|
|
| Hospital Charge Code |
270658289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$522.75 |
| Max. Negotiated Rate |
$522.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$522.75
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
IP
|
$2,968.00
|
|
| Hospital Charge Code |
270658289N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.20 |
| Max. Negotiated Rate |
$445.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$445.20
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
OP
|
$3,485.00
|
|
| Hospital Charge Code |
270658289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$453.05 |
| Max. Negotiated Rate |
$1,742.50 |
| Rate for Payer: Aetna Commercial |
$1,045.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,045.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$888.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$888.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$888.67
|
| Rate for Payer: Cigna Commercial |
$1,742.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$453.05
|
| Rate for Payer: Oxford Commercial |
$1,742.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$522.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,742.50
|
|
|
CATHETER PROGREAT COAXIAL
|
Facility
|
OP
|
$2,800.00
|
|
| Hospital Charge Code |
270658289S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$1,400.00 |
| Rate for Payer: Aetna Commercial |
$840.00
|
| Rate for Payer: Aetna Medicare Advantage |
$840.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$714.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$714.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$714.00
|
| Rate for Payer: Cigna Commercial |
$1,400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$364.00
|
| Rate for Payer: Oxford Commercial |
$1,400.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,400.00
|
|