|
CATH FOLEY 26FR 3WAY 30cc
|
Facility
|
OP
|
$63.50
|
|
| Hospital Charge Code |
270649437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$31.75 |
| Rate for Payer: Aetna Commercial |
$24.13
|
| Rate for Payer: Aetna Medicare Advantage |
$19.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.19
|
| Rate for Payer: Cigna Commercial |
$31.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.51
|
| Rate for Payer: Oxford Commercial |
$12.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.80
|
|
|
CATH FOLEY 26FR 3WAY 30cc
|
Facility
|
IP
|
$63.50
|
|
| Hospital Charge Code |
270649437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$9.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.53
|
|
|
CATH FOLEY 2-WAY 12FR 30CC
|
Facility
|
IP
|
$12.30
|
|
| Hospital Charge Code |
270302631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$1.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.84
|
|
|
CATH FOLEY 2-WAY 12FR 30CC
|
Facility
|
OP
|
$12.30
|
|
| Hospital Charge Code |
270302631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$6.15 |
| Rate for Payer: Aetna Commercial |
$4.67
|
| Rate for Payer: Aetna Medicare Advantage |
$3.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.14
|
| Rate for Payer: Cigna Commercial |
$6.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.20
|
| Rate for Payer: Oxford Commercial |
$2.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.46
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.35
|
|
|
CATH FOLEY 2-WAY 14FR 30CC
|
Facility
|
OP
|
$12.30
|
|
| Hospital Charge Code |
270302635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$6.15 |
| Rate for Payer: Aetna Commercial |
$4.67
|
| Rate for Payer: Aetna Medicare Advantage |
$3.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.14
|
| Rate for Payer: Cigna Commercial |
$6.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.20
|
| Rate for Payer: Oxford Commercial |
$2.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.46
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.35
|
|
|
CATH FOLEY 2-WAY 14FR 30CC
|
Facility
|
IP
|
$12.30
|
|
| Hospital Charge Code |
270302635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$1.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.84
|
|
|
CATH FOLEY 2-WAY 14FR 5CC
|
Facility
|
OP
|
$88.00
|
|
| Hospital Charge Code |
270302455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$44.00 |
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna Medicare Advantage |
$26.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.44
|
| Rate for Payer: Cigna Commercial |
$44.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.88
|
| Rate for Payer: Oxford Commercial |
$17.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.50
|
|
|
CATH FOLEY 2-WAY 14FR 5CC
|
Facility
|
IP
|
$39.25
|
|
| Hospital Charge Code |
270302545
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$5.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
|
|
CATH FOLEY 2-WAY 14FR 5CC
|
Facility
|
IP
|
$88.00
|
|
| Hospital Charge Code |
270302455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$13.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
|
|
CATH FOLEY 2-WAY 14FR 5CC
|
Facility
|
OP
|
$39.25
|
|
| Hospital Charge Code |
270302545
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$19.62 |
| Rate for Payer: Aetna Commercial |
$14.91
|
| Rate for Payer: Aetna Medicare Advantage |
$11.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.01
|
| Rate for Payer: Cigna Commercial |
$19.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.21
|
| Rate for Payer: Oxford Commercial |
$7.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.11
|
|
|
CATH FOLEY 2-WAY 16FR 30CC
|
Facility
|
IP
|
$12.54
|
|
| Hospital Charge Code |
270302575
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
|
|
CATH FOLEY 2-WAY 16FR 30CC
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
270302575
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Aetna Commercial |
$4.77
|
| Rate for Payer: Aetna Medicare Advantage |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.20
|
| Rate for Payer: Cigna Commercial |
$6.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.26
|
| Rate for Payer: Oxford Commercial |
$2.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
CATH FOLEY 2-WAY 16FR 5CC
|
Facility
|
OP
|
$39.25
|
|
| Hospital Charge Code |
270302530
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$19.62 |
| Rate for Payer: Aetna Commercial |
$14.91
|
| Rate for Payer: Aetna Medicare Advantage |
$11.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.01
|
| Rate for Payer: Cigna Commercial |
$19.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.21
|
| Rate for Payer: Oxford Commercial |
$7.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.11
|
|
|
CATH FOLEY 2-WAY 16FR 5CC
|
Facility
|
IP
|
$39.25
|
|
| Hospital Charge Code |
270302530
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$5.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
|
|
CATH FOLEY 2-WAY 18FR 30CC
|
Facility
|
IP
|
$12.54
|
|
| Hospital Charge Code |
270302580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
|
|
CATH FOLEY 2-WAY 18FR 30CC
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
270302580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Aetna Commercial |
$4.77
|
| Rate for Payer: Aetna Medicare Advantage |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.20
|
| Rate for Payer: Cigna Commercial |
$6.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.26
|
| Rate for Payer: Oxford Commercial |
$2.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
CATH FOLEY 2-WAY 18FR 5CC
|
Facility
|
OP
|
$9.77
|
|
| Hospital Charge Code |
270302540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$4.88 |
| Rate for Payer: Aetna Commercial |
$3.71
|
| Rate for Payer: Aetna Medicare Advantage |
$2.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.49
|
| Rate for Payer: Cigna Commercial |
$4.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.54
|
| Rate for Payer: Oxford Commercial |
$1.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.28
|
|
|
CATH FOLEY 2-WAY 18FR 5CC
|
Facility
|
IP
|
$9.77
|
|
| Hospital Charge Code |
270302540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$1.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.47
|
|
|
CATH FOLEY 2-WAY 20FR 30CC
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
270302585
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Aetna Commercial |
$4.77
|
| Rate for Payer: Aetna Medicare Advantage |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.20
|
| Rate for Payer: Cigna Commercial |
$6.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.26
|
| Rate for Payer: Oxford Commercial |
$2.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
CATH FOLEY 2-WAY 20FR 30CC
|
Facility
|
IP
|
$12.54
|
|
| Hospital Charge Code |
270302585
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
|
|
CATH FOLEY 2-WAY 20FR 5CC
|
Facility
|
IP
|
$38.88
|
|
| Hospital Charge Code |
270302560
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$5.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.83
|
|
|
CATH FOLEY 2-WAY 20FR 5CC
|
Facility
|
OP
|
$38.88
|
|
| Hospital Charge Code |
270302560
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$19.44 |
| Rate for Payer: Aetna Commercial |
$14.77
|
| Rate for Payer: Aetna Medicare Advantage |
$11.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.91
|
| Rate for Payer: Cigna Commercial |
$19.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.11
|
| Rate for Payer: Oxford Commercial |
$7.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.78
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.10
|
|
|
CATH FOLEY 2-WAY 22FR 30CC
|
Facility
|
IP
|
$12.54
|
|
| Hospital Charge Code |
270302590
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
|
|
CATH FOLEY 2-WAY 22FR 30CC
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
270302590
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Aetna Commercial |
$4.77
|
| Rate for Payer: Aetna Medicare Advantage |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.20
|
| Rate for Payer: Cigna Commercial |
$6.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.26
|
| Rate for Payer: Oxford Commercial |
$2.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
CATH FOLEY 2-WAY 22FR 5CC
|
Facility
|
OP
|
$39.25
|
|
| Hospital Charge Code |
270302565
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$19.62 |
| Rate for Payer: Aetna Commercial |
$14.91
|
| Rate for Payer: Aetna Medicare Advantage |
$11.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.01
|
| Rate for Payer: Cigna Commercial |
$19.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.21
|
| Rate for Payer: Oxford Commercial |
$7.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.11
|
|