|
NEEDLE GUIDE KIT SITE RITE
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
270649422N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$28.50
|
| Rate for Payer: Aetna Medicare Advantage |
$22.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.12
|
| Rate for Payer: Cigna Commercial |
$37.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.50
|
| Rate for Payer: Oxford Commercial |
$15.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.13
|
|
|
NEEDLE GUIDE KIT SITE RITE
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
270649422N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
|
|
NEEDLE GUIDE KIT SITE RITE
|
Facility
|
IP
|
$90.00
|
|
| Hospital Charge Code |
270649422S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.50
|
|
|
NEEDLE GUIDE KIT SITE RITE
|
Facility
|
OP
|
$90.00
|
|
| Hospital Charge Code |
270649422S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Aetna Medicare Advantage |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.95
|
| Rate for Payer: Cigna Commercial |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.40
|
| Rate for Payer: Oxford Commercial |
$18.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.56
|
|
|
NEEDLE GUIDE KIT SITE RITE
|
Facility
|
IP
|
$90.00
|
|
| Hospital Charge Code |
270649422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.50
|
|
|
NEEDLE GUIDE KIT SITE RITE
|
Facility
|
OP
|
$90.00
|
|
| Hospital Charge Code |
270649422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Aetna Medicare Advantage |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.95
|
| Rate for Payer: Cigna Commercial |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.40
|
| Rate for Payer: Oxford Commercial |
$18.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.56
|
|
|
NEEDLE HAWKINS III 20Gx7.5CM
|
Facility
|
IP
|
$175.50
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270677884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$42.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.32
|
|
|
NEEDLE HAWKINS III 20Gx7.5CM
|
Facility
|
OP
|
$175.50
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270677884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Aetna Commercial |
$66.69
|
| Rate for Payer: Aetna Medicare Advantage |
$52.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.75
|
| Rate for Payer: Cigna Commercial |
$87.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.98
|
|
|
NEEDLE HAWKINS III 3CM 20GX3CM
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$53.20
|
| Rate for Payer: Aetna Medicare Advantage |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.70
|
| Rate for Payer: Cigna Commercial |
$70.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.98
|
|
|
NEEDLE HAWKINS III 3CM 20GX3CM
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$33.88 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
|
|
NEEDLE HIP SCORPION
|
Facility
|
OP
|
$4,875.00
|
|
| Hospital Charge Code |
270680582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.45 |
| Max. Negotiated Rate |
$2,437.50 |
| Rate for Payer: Aetna Commercial |
$1,852.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,462.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,243.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,243.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,243.12
|
| Rate for Payer: Cigna Commercial |
$2,437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,267.50
|
| Rate for Payer: Oxford Commercial |
$975.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$731.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$154.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$138.45
|
|
|
NEEDLE HIP SCORPION
|
Facility
|
IP
|
$4,875.00
|
|
| Hospital Charge Code |
270680582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$731.25 |
| Max. Negotiated Rate |
$731.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$731.25
|
|
|
NEEDLE HOLDER FINE 7MM
|
Facility
|
IP
|
$1,872.00
|
|
| Hospital Charge Code |
270683685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$280.80 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$280.80
|
|
|
NEEDLE HOLDER FINE 7MM
|
Facility
|
OP
|
$1,872.00
|
|
| Hospital Charge Code |
270683685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.16 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Commercial |
$711.36
|
| Rate for Payer: Aetna Medicare Advantage |
$561.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$477.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$477.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$477.36
|
| Rate for Payer: Cigna Commercial |
$936.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$486.72
|
| Rate for Payer: Oxford Commercial |
$374.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$280.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$374.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.16
|
|
|
NEEDLE HOMER MAMOLOK 20G 5.0CM
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270607250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$72.50 |
| Rate for Payer: Aetna Commercial |
$55.10
|
| Rate for Payer: Aetna Medicare Advantage |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.98
|
| Rate for Payer: Cigna Commercial |
$72.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.12
|
|
|
NEEDLE HOMER MAMOLOK 20G 5.0CM
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270607250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.75 |
| Max. Negotiated Rate |
$35.09 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
|
|
NEEDLE HOMER MAMOLOK 20G 7.5CM
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270607251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$72.50 |
| Rate for Payer: Aetna Commercial |
$55.10
|
| Rate for Payer: Aetna Medicare Advantage |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.98
|
| Rate for Payer: Cigna Commercial |
$72.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.12
|
|
|
NEEDLE HOMER MAMOLOK 20G 7.5CM
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270607251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.75 |
| Max. Negotiated Rate |
$35.09 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
|
|
NEEDLE HUBER 19G 1 WINGED
|
Facility
|
OP
|
$20.41
|
|
| Hospital Charge Code |
270302846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$10.21 |
| Rate for Payer: Aetna Commercial |
$7.76
|
| Rate for Payer: Aetna Medicare Advantage |
$6.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.20
|
| Rate for Payer: Cigna Commercial |
$10.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.31
|
| Rate for Payer: Oxford Commercial |
$4.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
NEEDLE HUBER 19G 1 WINGED
|
Facility
|
IP
|
$20.41
|
|
| Hospital Charge Code |
270302846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
NEEDLE HUBER 20G 1
|
Facility
|
OP
|
$66.75
|
|
| Hospital Charge Code |
270649978
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$33.38 |
| Rate for Payer: Aetna Commercial |
$25.36
|
| Rate for Payer: Aetna Medicare Advantage |
$20.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.02
|
| Rate for Payer: Cigna Commercial |
$33.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.36
|
| Rate for Payer: Oxford Commercial |
$13.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.90
|
|
|
NEEDLE HUBER 20G 1
|
Facility
|
IP
|
$66.75
|
|
| Hospital Charge Code |
270649978
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$10.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.01
|
|
|
NEEDLE HYPO PRO EDGE 21GX1.5
|
Facility
|
OP
|
$0.76
|
|
| Hospital Charge Code |
270660096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.38 |
| Rate for Payer: Aetna Commercial |
$0.29
|
| Rate for Payer: Aetna Medicare Advantage |
$0.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.19
|
| Rate for Payer: Cigna Commercial |
$0.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.20
|
| Rate for Payer: Oxford Commercial |
$0.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.02
|
|
|
NEEDLE HYPO PRO EDGE 21GX1.5
|
Facility
|
IP
|
$0.76
|
|
| Hospital Charge Code |
270660096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.11
|
|
|
NEEDLE IMBIBE MARROW 8G 6INL
|
Facility
|
OP
|
$1,750.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
270698866
|
|
Hospital Revenue Code
|
272
|
| 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
|
|