|
HANDLE
|
Facility
|
OP
|
$1,575.00
|
|
| Hospital Charge Code |
270656681
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Aetna Commercial |
$598.50
|
| Rate for Payer: Aetna Medicare Advantage |
$472.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$401.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$401.62
|
| Rate for Payer: Cigna Commercial |
$787.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$409.50
|
| Rate for Payer: Oxford Commercial |
$315.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$315.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$49.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$44.73
|
|
|
HANDLE
|
Facility
|
IP
|
$1,575.00
|
|
| Hospital Charge Code |
270656681
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$236.25 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$236.25
|
|
|
HANDLE ENDO GIA 4 STANDARD STR
|
Facility
|
IP
|
$1,188.68
|
|
| Hospital Charge Code |
270652109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.30 |
| Max. Negotiated Rate |
$178.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.30
|
|
|
HANDLE ENDO GIA 4 STANDARD STR
|
Facility
|
OP
|
$1,188.68
|
|
| Hospital Charge Code |
270652109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.76 |
| Max. Negotiated Rate |
$594.34 |
| Rate for Payer: Aetna Commercial |
$451.70
|
| Rate for Payer: Aetna Medicare Advantage |
$356.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$303.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$303.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$303.11
|
| Rate for Payer: Cigna Commercial |
$594.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$309.06
|
| Rate for Payer: Oxford Commercial |
$237.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$237.74
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.76
|
|
|
HANDLE FLIPCUTTER
|
Facility
|
IP
|
$2,625.00
|
|
| Hospital Charge Code |
270679853
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$393.75 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$393.75
|
|
|
HANDLE FLIPCUTTER
|
Facility
|
OP
|
$2,625.00
|
|
| Hospital Charge Code |
270679853
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$1,312.50 |
| Rate for Payer: Aetna Commercial |
$997.50
|
| Rate for Payer: Aetna Medicare Advantage |
$787.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$669.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$669.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$669.38
|
| Rate for Payer: Cigna Commercial |
$1,312.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$682.50
|
| Rate for Payer: Oxford Commercial |
$525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$393.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$525.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$82.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.55
|
|
|
HANDLE JEWELERS KNOB AO
|
Facility
|
OP
|
$1,750.00
|
|
| Hospital Charge Code |
270690429
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$665.00
|
| Rate for Payer: Aetna Medicare Advantage |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$446.25
|
| Rate for Payer: Cigna Commercial |
$875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$455.00
|
| Rate for Payer: Oxford Commercial |
$350.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$350.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$55.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.70
|
|
|
HANDLE JEWELERS KNOB AO
|
Facility
|
IP
|
$1,750.00
|
|
| Hospital Charge Code |
270690429
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$262.50 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
|
|
HANDLE LED FIBER OPTIC PENLIGH
|
Facility
|
OP
|
$445.00
|
|
| Hospital Charge Code |
270683069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$222.50 |
| Rate for Payer: Aetna Commercial |
$169.10
|
| Rate for Payer: Aetna Medicare Advantage |
$133.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$113.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$113.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$113.47
|
| Rate for Payer: Cigna Commercial |
$222.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.70
|
| Rate for Payer: Oxford Commercial |
$89.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$89.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.64
|
|
|
HANDLE LED FIBER OPTIC PENLIGH
|
Facility
|
IP
|
$445.00
|
|
| Hospital Charge Code |
270683069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.75 |
| Max. Negotiated Rate |
$66.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.75
|
|
|
HANDLE LIGASURE MARYLAND 44 CM
|
Facility
|
IP
|
$2,931.60
|
|
| Hospital Charge Code |
270691741
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$439.74 |
| Max. Negotiated Rate |
$439.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$439.74
|
|
|
HANDLE LIGASURE MARYLAND 44 CM
|
Facility
|
OP
|
$2,931.60
|
|
| Hospital Charge Code |
270691741
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.26 |
| Max. Negotiated Rate |
$1,465.80 |
| Rate for Payer: Aetna Commercial |
$1,114.01
|
| Rate for Payer: Aetna Medicare Advantage |
$879.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$747.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$747.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$747.56
|
| Rate for Payer: Cigna Commercial |
$1,465.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$762.22
|
| Rate for Payer: Oxford Commercial |
$586.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$439.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$586.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$92.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$83.26
|
|
|
HANDLE LONG SCALPEL
|
Facility
|
OP
|
$6,665.55
|
|
| Hospital Charge Code |
270691503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.30 |
| Max. Negotiated Rate |
$3,332.78 |
| Rate for Payer: Aetna Commercial |
$2,532.91
|
| Rate for Payer: Aetna Medicare Advantage |
$1,999.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,699.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,699.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,699.72
|
| Rate for Payer: Cigna Commercial |
$3,332.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,733.04
|
| Rate for Payer: Oxford Commercial |
$1,333.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$999.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,333.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$189.30
|
|
|
HANDLE LONG SCALPEL
|
Facility
|
IP
|
$6,665.55
|
|
| Hospital Charge Code |
270691503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$999.83 |
| Max. Negotiated Rate |
$999.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$999.83
|
|
|
HANDLE QUICK RATCHETING
|
Facility
|
OP
|
$4,950.00
|
|
| Hospital Charge Code |
270690997
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.58 |
| Max. Negotiated Rate |
$2,475.00 |
| Rate for Payer: Aetna Commercial |
$1,881.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,485.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,262.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,262.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,262.25
|
| Rate for Payer: Cigna Commercial |
$2,475.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,287.00
|
| Rate for Payer: Oxford Commercial |
$990.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$742.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$990.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$156.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$140.58
|
|
|
HANDLE QUICK RATCHETING
|
Facility
|
IP
|
$4,950.00
|
|
| Hospital Charge Code |
270690997
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$742.50 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$742.50
|
|
|
HANDLE SCREWDRIVER RATCHETING
|
Facility
|
OP
|
$2,365.00
|
|
| Hospital Charge Code |
270684772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$67.17 |
| Max. Negotiated Rate |
$1,182.50 |
| Rate for Payer: Aetna Commercial |
$898.70
|
| Rate for Payer: Aetna Medicare Advantage |
$709.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$603.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$603.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$603.08
|
| Rate for Payer: Cigna Commercial |
$1,182.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$614.90
|
| Rate for Payer: Oxford Commercial |
$473.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$354.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$473.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$74.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$67.17
|
|
|
HANDLE SCREWDRIVER RATCHETING
|
Facility
|
IP
|
$2,365.00
|
|
| Hospital Charge Code |
270684772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$354.75 |
| Max. Negotiated Rate |
$354.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$354.75
|
|
|
HANDLE T W/QUICK COUPLING
|
Facility
|
IP
|
$1,257.65
|
|
| Hospital Charge Code |
270614764
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.65 |
| Max. Negotiated Rate |
$188.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.65
|
|
|
HANDLE T W/QUICK COUPLING
|
Facility
|
OP
|
$1,257.65
|
|
| Hospital Charge Code |
270614764
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$628.83 |
| Rate for Payer: Aetna Commercial |
$477.91
|
| Rate for Payer: Aetna Medicare Advantage |
$377.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$320.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$320.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$320.70
|
| Rate for Payer: Cigna Commercial |
$628.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$326.99
|
| Rate for Payer: Oxford Commercial |
$251.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$251.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.72
|
|
|
HANDLE T W/QUICK COUPLING SM
|
Facility
|
IP
|
$1,425.85
|
|
| Hospital Charge Code |
270682612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.88 |
| Max. Negotiated Rate |
$213.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$213.88
|
|
|
HANDLE T W/QUICK COUPLING SM
|
Facility
|
OP
|
$1,425.85
|
|
| Hospital Charge Code |
270682612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.49 |
| Max. Negotiated Rate |
$712.92 |
| Rate for Payer: Aetna Commercial |
$541.82
|
| Rate for Payer: Aetna Medicare Advantage |
$427.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$363.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$363.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$363.59
|
| Rate for Payer: Cigna Commercial |
$712.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$370.72
|
| Rate for Payer: Oxford Commercial |
$285.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$213.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$285.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.49
|
|
|
HANDLE W/QK COUPLNG ROTATG CAP
|
Facility
|
OP
|
$1,959.05
|
|
| Hospital Charge Code |
270677604
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.64 |
| Max. Negotiated Rate |
$979.52 |
| Rate for Payer: Aetna Commercial |
$744.44
|
| Rate for Payer: Aetna Medicare Advantage |
$587.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$499.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$499.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$499.56
|
| Rate for Payer: Cigna Commercial |
$979.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$509.35
|
| Rate for Payer: Oxford Commercial |
$391.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$293.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$391.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$61.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55.64
|
|
|
HANDLE W/QK COUPLNG ROTATG CAP
|
Facility
|
IP
|
$1,959.05
|
|
| Hospital Charge Code |
270677604
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$293.86 |
| Max. Negotiated Rate |
$293.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$293.86
|
|
|
HAND NEBULIZER SUBSEQ TREATMNT
|
Facility
|
OP
|
$503.00
|
|
|
Service Code
|
HCPCS 9464076
|
| Hospital Charge Code |
9500325
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Aetna Commercial |
$191.14
|
| Rate for Payer: Aetna Medicare Advantage |
$150.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$128.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$128.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$128.26
|
| Rate for Payer: Cigna Commercial |
$251.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.78
|
| Rate for Payer: Oxford Commercial |
$1,367.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,440.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.29
|
|