|
CATHETER THORACIC STR.24FR
|
Facility
|
IP
|
$20.47
|
|
| Hospital Charge Code |
270649068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$3.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.07
|
|
|
CATHETER THORACIC STR.24FR
|
Facility
|
OP
|
$20.47
|
|
| Hospital Charge Code |
270649068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$10.23 |
| Rate for Payer: Aetna Commercial |
$7.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.22
|
| Rate for Payer: Cigna Commercial |
$10.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.32
|
| Rate for Payer: Oxford Commercial |
$4.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
CATHETER THREE LUMEN KIT 20CM
|
Facility
|
OP
|
$735.00
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
270698019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$367.50 |
| Rate for Payer: Aetna Commercial |
$279.30
|
| Rate for Payer: Aetna Medicare Advantage |
$220.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$187.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$187.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$187.43
|
| Rate for Payer: Cigna Commercial |
$367.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$177.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$110.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.87
|
|
|
CATHETER THREE LUMEN KIT 20CM
|
Facility
|
IP
|
$735.00
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
270698019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.25 |
| Max. Negotiated Rate |
$177.87 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$177.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$110.25
|
|
|
CATHETER,THROMBOLECTOMY,EMBOL
|
Facility
|
OP
|
$21.40
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
4800900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Aetna Commercial |
$8.13
|
| Rate for Payer: Aetna Medicare Advantage |
$6.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.46
|
| Rate for Payer: Cigna Commercial |
$10.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.61
|
|
|
CATHETER,THROMBOLECTOMY,EMBOL
|
Facility
|
IP
|
$21.40
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
4800900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$5.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
|
|
CATHETER TIEMANN COUDE 22FR
|
Facility
|
OP
|
$139.00
|
|
| Hospital Charge Code |
270311612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$69.50 |
| Rate for Payer: Aetna Commercial |
$52.82
|
| Rate for Payer: Aetna Medicare Advantage |
$41.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.45
|
| Rate for Payer: Cigna Commercial |
$69.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.14
|
| Rate for Payer: Oxford Commercial |
$27.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.95
|
|
|
CATHETER TIEMANN COUDE 22FR
|
Facility
|
IP
|
$139.00
|
|
| Hospital Charge Code |
270311612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.85 |
| Max. Negotiated Rate |
$20.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.85
|
|
|
CATHETER TIEMANN COUDE 5CC 22
|
Facility
|
IP
|
$106.00
|
|
| Hospital Charge Code |
270331133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$15.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.90
|
|
|
CATHETER TIEMANN COUDE 5CC 22
|
Facility
|
OP
|
$106.00
|
|
| Hospital Charge Code |
270331133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$53.00 |
| Rate for Payer: Aetna Commercial |
$40.28
|
| Rate for Payer: Aetna Medicare Advantage |
$31.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.03
|
| Rate for Payer: Cigna Commercial |
$53.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.56
|
| Rate for Payer: Oxford Commercial |
$21.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.01
|
|
|
CATHETER TIGERTAIL FLEX TIP
|
Facility
|
IP
|
$95.35
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
270650582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$14.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.30
|
|
|
CATHETER TIGERTAIL FLEX TIP
|
Facility
|
OP
|
$95.35
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
270650582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$47.67 |
| Rate for Payer: Aetna Commercial |
$36.23
|
| Rate for Payer: Aetna Medicare Advantage |
$28.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.31
|
| Rate for Payer: Cigna Commercial |
$47.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.79
|
| Rate for Payer: Oxford Commercial |
$19.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.71
|
|
|
CATHETER TIGERTIEVER 17 23MM
|
Facility
|
OP
|
$34,000.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270694967S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$965.60 |
| Max. Negotiated Rate |
$17,000.00 |
| Rate for Payer: Aetna Commercial |
$12,920.00
|
| Rate for Payer: Aetna Medicare Advantage |
$10,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,670.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,670.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,670.00
|
| Rate for Payer: Cigna Commercial |
$17,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,228.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,100.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,074.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$965.60
|
|
|
CATHETER TIGERTIEVER 17 23MM
|
Facility
|
IP
|
$34,000.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270694967S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,100.00 |
| Max. Negotiated Rate |
$8,228.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,228.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,100.00
|
|
|
CATHETER TIP 5FR 65CM RIM
|
Facility
|
IP
|
$561.00
|
|
| Hospital Charge Code |
270675909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.15 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.15
|
|
|
CATHETER TIP 5FR 65CM RIM
|
Facility
|
OP
|
$561.00
|
|
| Hospital Charge Code |
270675909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.93 |
| Max. Negotiated Rate |
$280.50 |
| Rate for Payer: Aetna Commercial |
$213.18
|
| Rate for Payer: Aetna Medicare Advantage |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$143.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$143.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$143.06
|
| Rate for Payer: Cigna Commercial |
$280.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.86
|
| Rate for Payer: Oxford Commercial |
$112.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$112.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.93
|
|
|
CATHETER TIP CULTURE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3036052
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CATHETER TIP CULTURE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3036052
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare Advantage |
$27.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.27
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.62
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.62
|
| 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 |
$6.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CATHETER TORCON C1 .038mmX65cm
|
Facility
|
OP
|
$74.30
|
|
| Hospital Charge Code |
270678586
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Aetna Commercial |
$28.23
|
| Rate for Payer: Aetna Medicare Advantage |
$22.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.95
|
| Rate for Payer: Cigna Commercial |
$37.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.32
|
| Rate for Payer: Oxford Commercial |
$14.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.86
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.11
|
|
|
CATHETER TORCON C1 .038mmX65cm
|
Facility
|
IP
|
$74.30
|
|
| Hospital Charge Code |
270678586
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
|
|
CATHETER TORCON C2 .038mmX65cm
|
Facility
|
OP
|
$74.30
|
|
| Hospital Charge Code |
270678587
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Aetna Commercial |
$28.23
|
| Rate for Payer: Aetna Medicare Advantage |
$22.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.95
|
| Rate for Payer: Cigna Commercial |
$37.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.32
|
| Rate for Payer: Oxford Commercial |
$14.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.86
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.11
|
|
|
CATHETER TORCON C2 .038mmX65cm
|
Facility
|
IP
|
$74.30
|
|
| Hospital Charge Code |
270678587
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
|
|
CATHETER TRAILBLAZER.035X135CM
|
Facility
|
IP
|
$4,864.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270689924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$729.60 |
| Max. Negotiated Rate |
$1,177.09 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$972.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,177.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$729.60
|
|
|
CATHETER TRAILBLAZER.035X135CM
|
Facility
|
OP
|
$4,864.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270689924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.14 |
| Max. Negotiated Rate |
$2,432.00 |
| Rate for Payer: Aetna Commercial |
$1,848.32
|
| Rate for Payer: Aetna Medicare Advantage |
$1,459.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,240.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,240.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$972.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,240.32
|
| Rate for Payer: Cigna Commercial |
$2,432.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,177.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$729.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$153.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$138.14
|
|
|
CATHETER TRAILBLAZER .035X150
|
Facility
|
OP
|
$4,864.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270683677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.14 |
| Max. Negotiated Rate |
$2,432.00 |
| Rate for Payer: Aetna Commercial |
$1,848.32
|
| Rate for Payer: Aetna Medicare Advantage |
$1,459.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,240.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,240.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$972.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,240.32
|
| Rate for Payer: Cigna Commercial |
$2,432.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,177.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$729.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$153.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$138.14
|
|