|
CANNULABIO-MEDICUS 19FR EA
|
Facility
|
IP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110E
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.10 |
| Max. Negotiated Rate |
$284.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
|
|
CANNULA, BIO-MEDICUS 21FR
|
Facility
|
OP
|
$2,114.00
|
|
| Hospital Charge Code |
2703110K
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.04 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$803.32
|
| Rate for Payer: Aetna Medicare Advantage |
$634.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$539.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$539.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$539.07
|
| Rate for Payer: Cigna Commercial |
$1,057.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$549.64
|
| Rate for Payer: Oxford Commercial |
$422.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$317.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$422.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$66.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.04
|
|
|
CANNULA, BIO-MEDICUS 21FR
|
Facility
|
IP
|
$2,114.00
|
|
| Hospital Charge Code |
2703110K
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$317.10 |
| Max. Negotiated Rate |
$317.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$317.10
|
|
|
CANNULABIO-MEDICUS 21FR EA
|
Facility
|
OP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110F
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.79 |
| Max. Negotiated Rate |
$947.00 |
| Rate for Payer: Aetna Commercial |
$719.72
|
| Rate for Payer: Aetna Medicare Advantage |
$568.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$482.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$482.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$482.97
|
| Rate for Payer: Cigna Commercial |
$947.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$492.44
|
| Rate for Payer: Oxford Commercial |
$378.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$378.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.79
|
|
|
CANNULABIO-MEDICUS 21FR EA
|
Facility
|
IP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110F
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.10 |
| Max. Negotiated Rate |
$284.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
|
|
CANNULA BIO-MEDICUS 23FR EA
|
Facility
|
IP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110G
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.10 |
| Max. Negotiated Rate |
$284.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
|
|
CANNULA BIO-MEDICUS 23FR EA
|
Facility
|
OP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110G
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.79 |
| Max. Negotiated Rate |
$947.00 |
| Rate for Payer: Aetna Commercial |
$719.72
|
| Rate for Payer: Aetna Medicare Advantage |
$568.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$482.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$482.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$482.97
|
| Rate for Payer: Cigna Commercial |
$947.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$492.44
|
| Rate for Payer: Oxford Commercial |
$378.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$378.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.79
|
|
|
CANNULA, BIO-MEDICUS 25FR
|
Facility
|
IP
|
$2,114.00
|
|
| Hospital Charge Code |
2703110IL
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$317.10 |
| Max. Negotiated Rate |
$317.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$317.10
|
|
|
CANNULA, BIO-MEDICUS 25FR
|
Facility
|
OP
|
$2,114.00
|
|
| Hospital Charge Code |
2703110IL
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.04 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$803.32
|
| Rate for Payer: Aetna Medicare Advantage |
$634.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$539.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$539.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$539.07
|
| Rate for Payer: Cigna Commercial |
$1,057.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$549.64
|
| Rate for Payer: Oxford Commercial |
$422.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$317.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$422.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$66.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.04
|
|
|
CANNULA BIO-MEDICUS 25FR EA
|
Facility
|
IP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110H
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.10 |
| Max. Negotiated Rate |
$284.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
|
|
CANNULA BIO-MEDICUS 25FR EA
|
Facility
|
OP
|
$1,894.00
|
|
| Hospital Charge Code |
2703110H
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.79 |
| Max. Negotiated Rate |
$947.00 |
| Rate for Payer: Aetna Commercial |
$719.72
|
| Rate for Payer: Aetna Medicare Advantage |
$568.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$482.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$482.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$482.97
|
| Rate for Payer: Cigna Commercial |
$947.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$492.44
|
| Rate for Payer: Oxford Commercial |
$378.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$378.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.79
|
|
|
CANNULA BLADELESS 7/8 MM
|
Facility
|
IP
|
$693.06
|
|
| Hospital Charge Code |
270692851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$103.96 |
| Max. Negotiated Rate |
$103.96 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.96
|
|
|
CANNULA BLADELESS 7/8 MM
|
Facility
|
OP
|
$693.06
|
|
| Hospital Charge Code |
270692851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.68 |
| Max. Negotiated Rate |
$346.53 |
| Rate for Payer: Aetna Commercial |
$263.36
|
| Rate for Payer: Aetna Medicare Advantage |
$207.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$176.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$176.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$176.73
|
| Rate for Payer: Cigna Commercial |
$346.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.20
|
| Rate for Payer: Oxford Commercial |
$138.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$138.61
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.68
|
|
|
CANNULA CAPS LOCK 70MMX8.6MM
|
Facility
|
IP
|
$162.50
|
|
| Hospital Charge Code |
270669993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.38 |
| Max. Negotiated Rate |
$24.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.38
|
|
|
CANNULA CAPS LOCK 70MMX8.6MM
|
Facility
|
OP
|
$162.50
|
|
| Hospital Charge Code |
270669993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$81.25 |
| Rate for Payer: Aetna Commercial |
$61.75
|
| Rate for Payer: Aetna Medicare Advantage |
$48.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.44
|
| Rate for Payer: Cigna Commercial |
$81.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.25
|
| Rate for Payer: Oxford Commercial |
$32.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.62
|
|
|
CANNULA CRYSTAL
|
Facility
|
OP
|
$180.00
|
|
| Hospital Charge Code |
270690874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$68.40
|
| Rate for Payer: Aetna Medicare Advantage |
$54.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.90
|
| Rate for Payer: Cigna Commercial |
$90.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.80
|
| Rate for Payer: Oxford Commercial |
$36.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.11
|
|
|
CANNULA CRYSTAL
|
Facility
|
IP
|
$180.00
|
|
| Hospital Charge Code |
270690874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
|
|
CANNULA CURVED FLAIR TIP W/7
|
Facility
|
OP
|
$77.80
|
|
| Hospital Charge Code |
270651733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$38.90 |
| Rate for Payer: Aetna Commercial |
$29.56
|
| Rate for Payer: Aetna Medicare Advantage |
$23.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.84
|
| Rate for Payer: Cigna Commercial |
$38.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.23
|
| Rate for Payer: Oxford Commercial |
$15.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.21
|
|
|
CANNULA CURVED FLAIR TIP W/7
|
Facility
|
IP
|
$77.80
|
|
| Hospital Charge Code |
270651733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$11.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.67
|
|
|
CANNULA CUT FLEX
|
Facility
|
OP
|
$325.00
|
|
| Hospital Charge Code |
270677468
|
|
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
|
|
|
CANNULA CUT FLEX
|
Facility
|
IP
|
$325.00
|
|
| Hospital Charge Code |
270677468
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
|
|
CANNULA DRI-LOK 8.0m3910075800
|
Facility
|
OP
|
$127.75
|
|
| Hospital Charge Code |
270641989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$63.88 |
| Rate for Payer: Aetna Commercial |
$48.55
|
| Rate for Payer: Aetna Medicare Advantage |
$38.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.58
|
| Rate for Payer: Cigna Commercial |
$63.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.22
|
| Rate for Payer: Oxford Commercial |
$25.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.63
|
|
|
CANNULA DRI-LOK 8.0m3910075800
|
Facility
|
IP
|
$127.75
|
|
| Hospital Charge Code |
270641989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$19.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.16
|
|
|
CANNULA ENDOPATH XCEL 11x100MM
|
Facility
|
OP
|
$90.00
|
|
| Hospital Charge Code |
270671543
|
|
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
|
|
|
CANNULA ENDOPATH XCEL 11x100MM
|
Facility
|
IP
|
$90.00
|
|
| Hospital Charge Code |
270671543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.50
|
|