|
TUBING GU IRRIGATION
|
Facility
|
IP
|
$26.67
|
|
| Hospital Charge Code |
270040325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.00
|
|
|
TUBING HIGH PRESS 72in HPF720E
|
Facility
|
IP
|
$30.90
|
|
| Hospital Charge Code |
270628012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$4.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.63
|
|
|
TUBING HIGH PRESS 72in HPF720E
|
Facility
|
OP
|
$30.90
|
|
| Hospital Charge Code |
270628012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$15.45 |
| Rate for Payer: Aetna Commercial |
$11.74
|
| Rate for Payer: Aetna Medicare Advantage |
$9.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.88
|
| Rate for Payer: Cigna Commercial |
$15.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.03
|
| Rate for Payer: Oxford Commercial |
$6.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.88
|
|
|
TUBING HIGH PRESSURE 100
|
Facility
|
OP
|
$40.50
|
|
| Hospital Charge Code |
270667655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna Commercial |
$15.39
|
| Rate for Payer: Aetna Medicare Advantage |
$12.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.33
|
| Rate for Payer: Cigna Commercial |
$20.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.53
|
| Rate for Payer: Oxford Commercial |
$8.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.15
|
|
|
TUBING HIGH PRESSURE 100
|
Facility
|
IP
|
$40.50
|
|
| Hospital Charge Code |
270667655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$6.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.08
|
|
|
TUBING HIGH PRESSURE 120 PSI
|
Facility
|
IP
|
$687.50
|
|
| Hospital Charge Code |
270663793
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$103.12 |
| Max. Negotiated Rate |
$103.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.12
|
|
|
TUBING HIGH PRESSURE 120 PSI
|
Facility
|
OP
|
$687.50
|
|
| Hospital Charge Code |
270663793
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$343.75 |
| Rate for Payer: Aetna Commercial |
$261.25
|
| Rate for Payer: Aetna Medicare Advantage |
$206.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$175.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$175.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$175.31
|
| Rate for Payer: Cigna Commercial |
$343.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.75
|
| Rate for Payer: Oxford Commercial |
$137.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.52
|
|
|
TUBING HIGH PRESSURE 20
|
Facility
|
OP
|
$357.50
|
|
| Hospital Charge Code |
270658345
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$178.75 |
| Rate for Payer: Aetna Commercial |
$135.85
|
| Rate for Payer: Aetna Medicare Advantage |
$107.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.16
|
| Rate for Payer: Cigna Commercial |
$178.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$92.95
|
| Rate for Payer: Oxford Commercial |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$71.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.15
|
|
|
TUBING HIGH PRESSURE 20
|
Facility
|
IP
|
$357.50
|
|
| Hospital Charge Code |
270658345
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$53.62 |
| Max. Negotiated Rate |
$53.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
IP
|
$13.75
|
|
| Hospital Charge Code |
270658323S
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$2.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
IP
|
$13.75
|
|
| Hospital Charge Code |
270658323
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$2.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
OP
|
$13.75
|
|
| Hospital Charge Code |
270658323S
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: Aetna Commercial |
$5.22
|
| Rate for Payer: Aetna Medicare Advantage |
$4.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.51
|
| Rate for Payer: Cigna Commercial |
$6.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.58
|
| Rate for Payer: Oxford Commercial |
$2.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.39
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
OP
|
$13.75
|
|
| Hospital Charge Code |
270658323
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: Aetna Commercial |
$5.22
|
| Rate for Payer: Aetna Medicare Advantage |
$4.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.51
|
| Rate for Payer: Cigna Commercial |
$6.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.58
|
| Rate for Payer: Oxford Commercial |
$2.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.39
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
IP
|
$16.40
|
|
| Hospital Charge Code |
270658323N
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$2.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.46
|
|
|
TUBING HI PRESSURE 900 HP9100E
|
Facility
|
OP
|
$16.40
|
|
| Hospital Charge Code |
270658323N
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$8.20 |
| Rate for Payer: Aetna Commercial |
$6.23
|
| Rate for Payer: Aetna Medicare Advantage |
$4.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.18
|
| Rate for Payer: Cigna Commercial |
$8.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.26
|
| Rate for Payer: Oxford Commercial |
$3.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.47
|
|
|
TUBING HYSTEROSCOPY
|
Facility
|
IP
|
$410.55
|
|
| Hospital Charge Code |
270650772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.58 |
| Max. Negotiated Rate |
$61.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.58
|
|
|
TUBING HYSTEROSCOPY
|
Facility
|
OP
|
$410.55
|
|
| Hospital Charge Code |
270650772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$205.28 |
| Rate for Payer: Aetna Commercial |
$156.01
|
| Rate for Payer: Aetna Medicare Advantage |
$123.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104.69
|
| Rate for Payer: Cigna Commercial |
$205.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.74
|
| Rate for Payer: Oxford Commercial |
$82.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$82.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.66
|
|
|
TUBING INFLOW CASSETTE CROSSFL
|
Facility
|
IP
|
$242.50
|
|
| Hospital Charge Code |
270673137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.38 |
| Max. Negotiated Rate |
$36.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.38
|
|
|
TUBING INFLOW CASSETTE CROSSFL
|
Facility
|
OP
|
$242.50
|
|
| Hospital Charge Code |
270673137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$121.25 |
| Rate for Payer: Aetna Commercial |
$92.15
|
| Rate for Payer: Aetna Medicare Advantage |
$72.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.84
|
| Rate for Payer: Cigna Commercial |
$121.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$63.05
|
| Rate for Payer: Oxford Commercial |
$48.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$48.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.89
|
|
|
TUBING INJECTOR ANGIO HI PRESS
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
270699058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$3.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.86
|
|
|
TUBING INJECTOR ANGIO HI PRESS
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
270699058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$12.88 |
| Rate for Payer: Aetna Commercial |
$9.79
|
| Rate for Payer: Aetna Medicare Advantage |
$7.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.57
|
| Rate for Payer: Cigna Commercial |
$12.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.70
|
| Rate for Payer: Oxford Commercial |
$5.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.73
|
|
|
TUBING INSUFFLATION 20L
|
Facility
|
OP
|
$51.60
|
|
| Hospital Charge Code |
270657496
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$25.80 |
| Rate for Payer: Aetna Commercial |
$19.61
|
| Rate for Payer: Aetna Medicare Advantage |
$15.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.16
|
| Rate for Payer: Cigna Commercial |
$25.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.42
|
| Rate for Payer: Oxford Commercial |
$10.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.47
|
|
|
TUBING INSUFFLATION 20L
|
Facility
|
IP
|
$51.60
|
|
| Hospital Charge Code |
270657496
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.74 |
| Max. Negotiated Rate |
$7.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.74
|
|
|
TUBING IV ADM UNIV SAFELE 1585
|
Facility
|
IP
|
$9.70
|
|
| Hospital Charge Code |
270645820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$1.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.46
|
|
|
TUBING IV ADM UNIV SAFELE 1585
|
Facility
|
OP
|
$9.70
|
|
| Hospital Charge Code |
270645820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$4.85 |
| Rate for Payer: Aetna Commercial |
$3.69
|
| Rate for Payer: Aetna Medicare Advantage |
$2.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.47
|
| Rate for Payer: Cigna Commercial |
$4.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.52
|
| Rate for Payer: Oxford Commercial |
$1.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.94
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.28
|
|
