|
STOCKINETTE 4 WIDE
|
Facility
|
IP
|
$64.90
|
|
| Hospital Charge Code |
270302960
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$9.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.73
|
|
|
STOCKINETTE 4 WIDE
|
Facility
|
OP
|
$64.90
|
|
| Hospital Charge Code |
270302960W
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$32.45 |
| Rate for Payer: Aetna Commercial |
$24.66
|
| Rate for Payer: Aetna Medicare Advantage |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.55
|
| Rate for Payer: Cigna Commercial |
$32.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.87
|
| Rate for Payer: Oxford Commercial |
$12.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.98
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.84
|
|
|
STOCKINETTE 6 WIDE
|
Facility
|
IP
|
$100.70
|
|
| Hospital Charge Code |
270302965
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.11 |
| Max. Negotiated Rate |
$15.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.11
|
|
|
STOCKINETTE 6 WIDE
|
Facility
|
OP
|
$100.70
|
|
| Hospital Charge Code |
270302965
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$50.35 |
| Rate for Payer: Aetna Commercial |
$38.27
|
| Rate for Payer: Aetna Medicare Advantage |
$30.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.68
|
| Rate for Payer: Cigna Commercial |
$50.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.18
|
| Rate for Payer: Oxford Commercial |
$20.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.14
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.86
|
|
|
STOCKINETTE 6 WIDE
|
Facility
|
OP
|
$100.70
|
|
| Hospital Charge Code |
270302965W
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$50.35 |
| Rate for Payer: Aetna Commercial |
$38.27
|
| Rate for Payer: Aetna Medicare Advantage |
$30.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.68
|
| Rate for Payer: Cigna Commercial |
$50.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.18
|
| Rate for Payer: Oxford Commercial |
$20.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.14
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.86
|
|
|
STOCKINETTE 6 WIDE
|
Facility
|
IP
|
$100.70
|
|
| Hospital Charge Code |
270302965W
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.11 |
| Max. Negotiated Rate |
$15.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.11
|
|
|
STOCKINETTE IMPERVIOUS 1587
|
Facility
|
OP
|
$16.45
|
|
| Hospital Charge Code |
270648976
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$8.22 |
| Rate for Payer: Aetna Commercial |
$6.25
|
| Rate for Payer: Aetna Medicare Advantage |
$4.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.19
|
| Rate for Payer: Cigna Commercial |
$8.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.28
|
| Rate for Payer: Oxford Commercial |
$3.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.47
|
|
|
STOCKINETTE IMPERVIOUS 1587
|
Facility
|
IP
|
$16.45
|
|
| Hospital Charge Code |
270648976
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$2.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.47
|
|
|
STOCKINETTE IMPERV STER
|
Facility
|
OP
|
$29.61
|
|
| Hospital Charge Code |
270061525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$14.80 |
| Rate for Payer: Aetna Commercial |
$11.25
|
| Rate for Payer: Aetna Medicare Advantage |
$8.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.55
|
| Rate for Payer: Cigna Commercial |
$14.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.70
|
| Rate for Payer: Oxford Commercial |
$5.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.92
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.84
|
|
|
STOCKINETTE IMPERV STER
|
Facility
|
IP
|
$29.61
|
|
| Hospital Charge Code |
270061525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$4.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.44
|
|
|
STOCKINETTE N/STAR 3X25 YD
|
Facility
|
OP
|
$55.25
|
|
| Hospital Charge Code |
270649012
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$27.62 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.09
|
| Rate for Payer: Cigna Commercial |
$27.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.37
|
| Rate for Payer: Oxford Commercial |
$11.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.57
|
|
|
STOCKINETTE N/STAR 3X25 YD
|
Facility
|
IP
|
$55.25
|
|
| Hospital Charge Code |
270649012
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$8.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.29
|
|
|
STOCKINETTE SPECIALIST 6X25YD
|
Facility
|
IP
|
$117.25
|
|
| Hospital Charge Code |
270663268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.59 |
| Max. Negotiated Rate |
$17.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.59
|
|
|
STOCKINETTE SPECIALIST 6X25YD
|
Facility
|
OP
|
$117.25
|
|
| Hospital Charge Code |
270663268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$58.62 |
| Rate for Payer: Aetna Commercial |
$44.55
|
| Rate for Payer: Aetna Medicare Advantage |
$35.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.90
|
| Rate for Payer: Cigna Commercial |
$58.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.48
|
| Rate for Payer: Oxford Commercial |
$23.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.33
|
|
|
STOCKINETTE STERILE 4X36 2PLY
|
Facility
|
OP
|
$30.42
|
|
| Hospital Charge Code |
270649008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$15.21 |
| Rate for Payer: Aetna Commercial |
$11.56
|
| Rate for Payer: Aetna Medicare Advantage |
$9.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.76
|
| Rate for Payer: Cigna Commercial |
$15.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.91
|
| Rate for Payer: Oxford Commercial |
$6.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.86
|
|
|
STOCKINETTE STERILE 4X36 2PLY
|
Facility
|
IP
|
$30.42
|
|
| Hospital Charge Code |
270649008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$4.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.56
|
|
|
STOCKINETTE STERILE 6X48 2PLY
|
Facility
|
IP
|
$26.21
|
|
| Hospital Charge Code |
270649010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$3.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.93
|
|
|
STOCKINETTE STERILE 6X48 2PLY
|
Facility
|
OP
|
$26.21
|
|
| Hospital Charge Code |
270649010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna Commercial |
$9.96
|
| Rate for Payer: Aetna Medicare Advantage |
$7.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.68
|
| Rate for Payer: Cigna Commercial |
$13.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.81
|
| Rate for Payer: Oxford Commercial |
$5.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.24
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.74
|
|
|
STOCKINETTE TUB 3X 25YD
|
Facility
|
OP
|
$224.00
|
|
| Hospital Charge Code |
270331386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$112.00 |
| Rate for Payer: Aetna Commercial |
$85.12
|
| Rate for Payer: Aetna Medicare Advantage |
$67.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.12
|
| Rate for Payer: Cigna Commercial |
$112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.24
|
| Rate for Payer: Oxford Commercial |
$44.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.36
|
|
|
STOCKINETTE TUB 3X 25YD
|
Facility
|
IP
|
$224.00
|
|
| Hospital Charge Code |
270331386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$33.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.60
|
|
|
STOCKINETTE TUBULAR
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
270602893
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$10.29 |
| Rate for Payer: Aetna Commercial |
$7.82
|
| Rate for Payer: Aetna Medicare Advantage |
$6.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.25
|
| Rate for Payer: Cigna Commercial |
$10.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.35
|
| Rate for Payer: Oxford Commercial |
$4.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
STOCKINETTE TUBULAR
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
270602893
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$3.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.09
|
|
|
STOCKINETTE TUBULAR 3X25
|
Facility
|
OP
|
$62.90
|
|
| Hospital Charge Code |
270653376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna Commercial |
$23.90
|
| Rate for Payer: Aetna Medicare Advantage |
$18.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.04
|
| Rate for Payer: Cigna Commercial |
$31.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.35
|
| Rate for Payer: Oxford Commercial |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.79
|
|
|
STOCKINETTE TUBULAR 3X25
|
Facility
|
IP
|
$62.90
|
|
| Hospital Charge Code |
270653376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$9.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.44
|
|
|
STOCKINETTE TUBULAR 4X25
|
Facility
|
IP
|
$82.55
|
|
| Hospital Charge Code |
270653377
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.38 |
| Max. Negotiated Rate |
$12.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.38
|
|