|
NEEDLE CAR LOCK INJEC 00711813
|
Facility
|
IP
|
$290.00
|
|
| Hospital Charge Code |
270644361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
|
|
NEEDLE CAR LOCK INJEC 00711813
|
Facility
|
OP
|
$290.00
|
|
| Hospital Charge Code |
270644361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna Commercial |
$110.20
|
| Rate for Payer: Aetna Medicare Advantage |
$87.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.95
|
| Rate for Payer: Cigna Commercial |
$145.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.40
|
| Rate for Payer: Oxford Commercial |
$58.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.24
|
|
|
NEEDLE CASSETTE FOR SPD-STITCH
|
Facility
|
IP
|
$515.00
|
|
| Hospital Charge Code |
270668392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.25 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.25
|
|
|
NEEDLE CASSETTE FOR SPD-STITCH
|
Facility
|
OP
|
$515.00
|
|
| Hospital Charge Code |
270668392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.63 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$195.70
|
| Rate for Payer: Aetna Medicare Advantage |
$154.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$131.32
|
| Rate for Payer: Cigna Commercial |
$257.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.90
|
| Rate for Payer: Oxford Commercial |
$103.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.63
|
|
|
NEEDLE CATHETER 5.0FR 19G 10CM
|
Facility
|
OP
|
$114.05
|
|
| Hospital Charge Code |
270658315R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$57.02 |
| Rate for Payer: Aetna Commercial |
$43.34
|
| Rate for Payer: Aetna Medicare Advantage |
$34.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.08
|
| Rate for Payer: Cigna Commercial |
$57.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.65
|
| Rate for Payer: Oxford Commercial |
$22.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.24
|
|
|
NEEDLE CATHETER 5.0FR 19G 10CM
|
Facility
|
IP
|
$114.05
|
|
| Hospital Charge Code |
270658315R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$17.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
|
|
NEEDLE CATHETER 5.0FR 19G 10CM
|
Facility
|
IP
|
$114.05
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270658315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$27.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
|
|
NEEDLE CATHETER 5.0FR 19G 10CM
|
Facility
|
OP
|
$114.05
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270658315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$57.02 |
| Rate for Payer: Aetna Commercial |
$43.34
|
| Rate for Payer: Aetna Medicare Advantage |
$34.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.08
|
| Rate for Payer: Cigna Commercial |
$57.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.24
|
|
|
NEEDLE CATHETER 5.0FR 19G 15CM
|
Facility
|
IP
|
$114.05
|
|
| Hospital Charge Code |
270661448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$17.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
|
|
NEEDLE CATHETER 5.0FR 19G 15CM
|
Facility
|
IP
|
$114.05
|
|
| Hospital Charge Code |
270661448R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$17.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
|
|
NEEDLE CATHETER 5.0FR 19G 15CM
|
Facility
|
OP
|
$114.05
|
|
| Hospital Charge Code |
270661448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$57.02 |
| Rate for Payer: Aetna Commercial |
$43.34
|
| Rate for Payer: Aetna Medicare Advantage |
$34.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.08
|
| Rate for Payer: Cigna Commercial |
$57.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.65
|
| Rate for Payer: Oxford Commercial |
$22.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.24
|
|
|
NEEDLE CATHETER 5.0FR 19G 15CM
|
Facility
|
OP
|
$114.05
|
|
| Hospital Charge Code |
270661448R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$57.02 |
| Rate for Payer: Aetna Commercial |
$43.34
|
| Rate for Payer: Aetna Medicare Advantage |
$34.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.08
|
| Rate for Payer: Cigna Commercial |
$57.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.65
|
| Rate for Payer: Oxford Commercial |
$22.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.81
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.24
|
|
|
NEEDLE CHIBA 18GX15CM ECHO TIP
|
Facility
|
IP
|
$59.50
|
|
| Hospital Charge Code |
270669582N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.93
|
|
|
NEEDLE CHIBA 18GX15CM ECHO TIP
|
Facility
|
OP
|
$57.50
|
|
| Hospital Charge Code |
270669582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$28.75 |
| Rate for Payer: Aetna Commercial |
$21.85
|
| Rate for Payer: Aetna Medicare Advantage |
$17.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.66
|
| Rate for Payer: Cigna Commercial |
$28.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Oxford Commercial |
$11.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.63
|
|
|
NEEDLE CHIBA 18GX15CM ECHO TIP
|
Facility
|
OP
|
$59.50
|
|
| Hospital Charge Code |
270669582N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$29.75 |
| Rate for Payer: Aetna Commercial |
$22.61
|
| Rate for Payer: Aetna Medicare Advantage |
$17.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.17
|
| Rate for Payer: Cigna Commercial |
$29.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.47
|
| Rate for Payer: Oxford Commercial |
$11.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.69
|
|
|
NEEDLE CHIBA 18GX15CM ECHO TIP
|
Facility
|
IP
|
$57.50
|
|
| Hospital Charge Code |
270669582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$8.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.62
|
|
|
NEEDLE CHIBA 18GX20CM ECHO TIP
|
Facility
|
IP
|
$59.50
|
|
| Hospital Charge Code |
270669581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.93
|
|
|
NEEDLE CHIBA 18GX20CM ECHO TIP
|
Facility
|
OP
|
$59.50
|
|
| Hospital Charge Code |
270669581
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$29.75 |
| Rate for Payer: Aetna Commercial |
$22.61
|
| Rate for Payer: Aetna Medicare Advantage |
$17.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.17
|
| Rate for Payer: Cigna Commercial |
$29.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.47
|
| Rate for Payer: Oxford Commercial |
$11.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.69
|
|
|
NEEDLE CHIBA BIOPSY DISPOSABLE
|
Facility
|
OP
|
$64.00
|
|
| Hospital Charge Code |
270331250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$32.00 |
| Rate for Payer: Aetna Commercial |
$24.32
|
| Rate for Payer: Aetna Medicare Advantage |
$19.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.32
|
| Rate for Payer: Cigna Commercial |
$32.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.64
|
| Rate for Payer: Oxford Commercial |
$12.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.82
|
|
|
NEEDLE CHIBA BIOPSY DISPOSABLE
|
Facility
|
IP
|
$64.00
|
|
| Hospital Charge Code |
270331250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
|
|
NEEDLE CLEAR 25G 4mm 240cm
|
Facility
|
OP
|
$153.00
|
|
| Hospital Charge Code |
270638513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$58.14
|
| Rate for Payer: Aetna Medicare Advantage |
$45.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.02
|
| Rate for Payer: Cigna Commercial |
$76.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.78
|
| Rate for Payer: Oxford Commercial |
$30.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.35
|
|
|
NEEDLE CLEAR 25G 4mm 240cm
|
Facility
|
IP
|
$153.00
|
|
| Hospital Charge Code |
270638513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.95 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.95
|
|
|
NEEDLE COAXIAL ACHIVE 14G 11CM
|
Facility
|
OP
|
$264.86
|
|
| Hospital Charge Code |
270645826R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.52 |
| Max. Negotiated Rate |
$132.43 |
| Rate for Payer: Aetna Commercial |
$100.65
|
| Rate for Payer: Aetna Medicare Advantage |
$79.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.54
|
| Rate for Payer: Cigna Commercial |
$132.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$68.86
|
| Rate for Payer: Oxford Commercial |
$52.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.52
|
|
|
NEEDLE COAXIAL ACHIVE 14G 11CM
|
Facility
|
IP
|
$264.86
|
|
| Hospital Charge Code |
270645826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.73 |
| Max. Negotiated Rate |
$39.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.73
|
|
|
NEEDLE COAXIAL ACHIVE 14G 11CM
|
Facility
|
OP
|
$264.86
|
|
| Hospital Charge Code |
270645826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.52 |
| Max. Negotiated Rate |
$132.43 |
| Rate for Payer: Aetna Commercial |
$100.65
|
| Rate for Payer: Aetna Medicare Advantage |
$79.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.54
|
| Rate for Payer: Cigna Commercial |
$132.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$68.86
|
| Rate for Payer: Oxford Commercial |
$52.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.52
|
|