|
CUP VERSAFITCUP 46MM
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270684248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$156.20 |
| Max. Negotiated Rate |
$2,750.00 |
| Rate for Payer: Aetna Commercial |
$2,090.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,402.50
|
| Rate for Payer: Cigna Commercial |
$2,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,331.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$173.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$156.20
|
|
|
CUP VERSAFITCUP 46MM
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270684248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$1,331.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,331.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.00
|
|
|
CURCIUT VENT M2290 SINGLE HEAT
|
Facility
|
OP
|
$1,227.60
|
|
| Hospital Charge Code |
270651836
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.86 |
| Max. Negotiated Rate |
$613.80 |
| Rate for Payer: Aetna Commercial |
$466.49
|
| Rate for Payer: Aetna Medicare Advantage |
$368.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$313.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$313.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$313.04
|
| Rate for Payer: Cigna Commercial |
$613.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$319.18
|
| Rate for Payer: Oxford Commercial |
$245.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$184.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$245.52
|
| Rate for Payer: UnitedHealthcare Community & State |
$38.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.86
|
|
|
CURCIUT VENT M2290 SINGLE HEAT
|
Facility
|
IP
|
$1,227.60
|
|
| Hospital Charge Code |
270651836
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$184.14 |
| Max. Negotiated Rate |
$184.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$184.14
|
|
|
CURE ACP DRILL S1-700-430-12
|
Facility
|
IP
|
$750.00
|
|
| Hospital Charge Code |
270702196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
CURE ACP DRILL S1-700-430-12
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
270702196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
CURETTE VAC 7MM CRV 40789-307
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270600251
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$9.65
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.60
|
| Rate for Payer: Oxford Commercial |
$5.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.72
|
|
|
CURETTE VAC 7MM CRV 40789-307
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270600251
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 10MM CRVD
|
Facility
|
IP
|
$23.92
|
|
| Hospital Charge Code |
270600253
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$3.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.59
|
|
|
CURETTE VACUUM 10MM CRVD
|
Facility
|
OP
|
$23.92
|
|
| Hospital Charge Code |
270600253
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$11.96 |
| Rate for Payer: Aetna Commercial |
$9.09
|
| Rate for Payer: Aetna Medicare Advantage |
$7.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.10
|
| Rate for Payer: Cigna Commercial |
$11.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.22
|
| Rate for Payer: Oxford Commercial |
$4.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.78
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.68
|
|
|
CURETTE VACUUM 10mm STR
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270600255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 10mm STR
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270600255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$9.65
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.60
|
| Rate for Payer: Oxford Commercial |
$5.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.72
|
|
|
CURETTE VACUUM 11MM STR
|
Facility
|
OP
|
$14.80
|
|
| Hospital Charge Code |
270677262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$7.40 |
| Rate for Payer: Aetna Commercial |
$5.62
|
| Rate for Payer: Aetna Medicare Advantage |
$4.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.77
|
| Rate for Payer: Cigna Commercial |
$7.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.85
|
| Rate for Payer: Oxford Commercial |
$2.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.96
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
CURETTE VACUUM 11MM STR
|
Facility
|
IP
|
$14.80
|
|
| Hospital Charge Code |
270677262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.22 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.22
|
|
|
CURETTE VACUUM 12mm CRVD
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270613956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$9.65
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.60
|
| Rate for Payer: Oxford Commercial |
$5.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.72
|
|
|
CURETTE VACUUM 12mm CRVD
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270613956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 12mm STR
|
Facility
|
IP
|
$25.40
|
|
| Hospital Charge Code |
270600256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
|
|
CURETTE VACUUM 12mm STR
|
Facility
|
OP
|
$25.40
|
|
| Hospital Charge Code |
270600256
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$9.65
|
| Rate for Payer: Aetna Medicare Advantage |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.48
|
| Rate for Payer: Cigna Commercial |
$12.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.60
|
| Rate for Payer: Oxford Commercial |
$5.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.72
|
|
|
CURETTE VACUUM 7MM RIGID STR
|
Facility
|
IP
|
$126.00
|
|
| Hospital Charge Code |
270656354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
|
|
CURETTE VACUUM 7MM RIGID STR
|
Facility
|
OP
|
$126.00
|
|
| Hospital Charge Code |
270656354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$47.88
|
| Rate for Payer: Aetna Medicare Advantage |
$37.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.13
|
| Rate for Payer: Cigna Commercial |
$63.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.76
|
| Rate for Payer: Oxford Commercial |
$25.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.58
|
|
|
CURETTE VACUUM 8mm CRVD
|
Facility
|
OP
|
$9.44
|
|
| Hospital Charge Code |
270600252
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$3.59
|
| Rate for Payer: Aetna Medicare Advantage |
$2.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.41
|
| Rate for Payer: Cigna Commercial |
$4.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.45
|
| Rate for Payer: Oxford Commercial |
$1.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.27
|
|
|
CURETTE VACUUM 8mm CRVD
|
Facility
|
IP
|
$9.44
|
|
| Hospital Charge Code |
270600252
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$1.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
|
|
CURETTE VACUUM 8MM RIGID STR
|
Facility
|
IP
|
$9.44
|
|
| Hospital Charge Code |
270600254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$1.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
|
|
CURETTE VACUUM 8MM RIGID STR
|
Facility
|
OP
|
$9.44
|
|
| Hospital Charge Code |
270600254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$3.59
|
| Rate for Payer: Aetna Medicare Advantage |
$2.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.41
|
| Rate for Payer: Cigna Commercial |
$4.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.45
|
| Rate for Payer: Oxford Commercial |
$1.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.27
|
|
|
CURETTE VACUUM 9MM RIGID STR
|
Facility
|
OP
|
$14.75
|
|
| Hospital Charge Code |
270656355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$7.38 |
| Rate for Payer: Aetna Commercial |
$5.61
|
| Rate for Payer: Aetna Medicare Advantage |
$4.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.76
|
| Rate for Payer: Cigna Commercial |
$7.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.83
|
| Rate for Payer: Oxford Commercial |
$2.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|