|
TUMARK EVIVA U 271 560
|
Facility
|
IP
|
$437.50
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669921
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.62 |
| Max. Negotiated Rate |
$105.88 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.62
|
|
|
TUMARK EVIVA X 251 551
|
Facility
|
IP
|
$325.00
|
|
| Hospital Charge Code |
270669922R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
|
|
TUMARK EVIVA X 251 551
|
Facility
|
OP
|
$325.00
|
|
| Hospital Charge Code |
270669922R
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$162.50 |
| Rate for Payer: Aetna Commercial |
$123.50
|
| Rate for Payer: Aetna Medicare Advantage |
$97.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.88
|
| Rate for Payer: Cigna Commercial |
$162.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.50
|
| Rate for Payer: Oxford Commercial |
$65.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.23
|
|
|
TUMARK EVIVA X 251 551
|
Facility
|
OP
|
$325.00
|
|
| Hospital Charge Code |
270669922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$162.50 |
| Rate for Payer: Aetna Commercial |
$123.50
|
| Rate for Payer: Aetna Medicare Advantage |
$97.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.88
|
| Rate for Payer: Cigna Commercial |
$162.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.50
|
| Rate for Payer: Oxford Commercial |
$65.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.23
|
|
|
TUMARK EVIVA X 251 551
|
Facility
|
IP
|
$325.00
|
|
| Hospital Charge Code |
270669922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
|
|
TUMOR NECROSIS FACTOR
|
Facility
|
IP
|
$998.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
3009842
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$149.70 |
| Max. Negotiated Rate |
$149.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.70
|
|
|
TUMOR NECROSIS FACTOR
|
Facility
|
OP
|
$998.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
3009842
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$499.00 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare Advantage |
$55.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.65
|
| Rate for Payer: Cigna Commercial |
$499.00
|
| Rate for Payer: Cigna Medicare Advantage |
$17.27
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.48
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.34
|
|
|
TUMS/500MG/TAB
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 536104815
|
| Hospital Charge Code |
60634097
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.52
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.04
|
| Rate for Payer: Oxford Commercial |
$0.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.11
|
|
|
TUMS/500MG/TAB
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 536104815
|
| Hospital Charge Code |
60634097
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
TUNA IGE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
401186003H
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.94
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
TUNA IGE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
401186003H
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
TUNNELER DISPOSABLE SCANLAN
|
Facility
|
OP
|
$189.00
|
|
| Hospital Charge Code |
270335287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$71.82
|
| Rate for Payer: Aetna Medicare Advantage |
$56.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.20
|
| Rate for Payer: Cigna Commercial |
$94.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.14
|
| Rate for Payer: Oxford Commercial |
$37.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.37
|
|
|
TUNNELER DISPOSABLE SCANLAN
|
Facility
|
IP
|
$189.00
|
|
| Hospital Charge Code |
270335287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$28.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.35
|
|
|
TUNNELER W/ SHEATH 17GAx10IN
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
270650399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
TUNNELER W/ SHEATH 17GAx10IN
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
270650399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.25
|
| Rate for Payer: Cigna Commercial |
$75.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.00
|
| Rate for Payer: Oxford Commercial |
$30.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.26
|
|
|
TUNNELING 35 CM TOOL
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
270679694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
TUNNELING 35 CM TOOL
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
270679694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$570.00
|
| Rate for Payer: Aetna Medicare Advantage |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.50
|
| Rate for Payer: Cigna Commercial |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$390.00
|
| Rate for Payer: Oxford Commercial |
$300.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$300.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
TUNNELING TOOL 12
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
270694158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$104.50
|
| Rate for Payer: Aetna Medicare Advantage |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.12
|
| Rate for Payer: Cigna Commercial |
$137.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Oxford Commercial |
$55.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.81
|
|
|
TUNNELING TOOL 12
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
270694158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
Tunneling Tool 20
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
270673712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
Tunneling Tool 20
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
270673712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$104.50
|
| Rate for Payer: Aetna Medicare Advantage |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.12
|
| Rate for Payer: Cigna Commercial |
$137.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Oxford Commercial |
$55.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.81
|
|
|
TUNNELING TOOL KIT NEUROST NEV
|
Facility
|
IP
|
$375.00
|
|
| Hospital Charge Code |
270693284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.25 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
|
|
TUNNELING TOOL KIT NEUROST NEV
|
Facility
|
OP
|
$375.00
|
|
| Hospital Charge Code |
270693284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare Advantage |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.62
|
| Rate for Payer: Cigna Commercial |
$187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.50
|
| Rate for Payer: Oxford Commercial |
$75.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.65
|
|
|
TUOHY EPIDURAL NEEDLE 17G X 6
|
Facility
|
IP
|
$120.00
|
|
| Hospital Charge Code |
270331713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
|
|
TUOHY EPIDURAL NEEDLE 17G X 6
|
Facility
|
OP
|
$120.00
|
|
| Hospital Charge Code |
270331713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$45.60
|
| Rate for Payer: Aetna Medicare Advantage |
$36.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.60
|
| Rate for Payer: Cigna Commercial |
$60.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.20
|
| Rate for Payer: Oxford Commercial |
$24.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.41
|
|