|
CATH QUIK CAT EXTRA 6FR6009001
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270648208C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$450.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$544.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$495.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
CATH QUIK CAT EXTRA 6FR6009001
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270640389
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$855.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$544.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$495.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59.62
|
|
|
CATH QUIK CAT EXTRA 6FR6009001
|
Facility
|
IP
|
$2,250.00
|
|
| Hospital Charge Code |
270640389
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$450.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$544.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$495.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
CATH QUIK CAT EXTRA 6FR6009001
|
Facility
|
OP
|
$2,250.00
|
|
| Hospital Charge Code |
270648208C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$855.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$544.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$495.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$54.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59.62
|
|
|
CATH RBU 3.5 W/SIDE LA6RBU35SH
|
Facility
|
OP
|
$650.00
|
|
| Hospital Charge Code |
270639610C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$247.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
CATH RBU 3.5 W/SIDE LA6RBU35SH
|
Facility
|
IP
|
$650.00
|
|
| Hospital Charge Code |
270639610C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
CATH RBU 4.0 W/SH
|
Facility
|
IP
|
$650.00
|
|
| Hospital Charge Code |
270639611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
CATH RBU 4.0 W/SH
|
Facility
|
OP
|
$650.00
|
|
| Hospital Charge Code |
270639611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$247.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
CATH RBU LAUNCHER 6FR 3.5
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636781N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
CATH RBU LAUNCHER 6FR 3.5
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636781N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$247.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
CATH RBU LAUNCHER 6FR 3.5
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636781
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna Commercial |
$93.10
|
| Rate for Payer: Aetna Medicare Advantage |
$73.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.48
|
| Rate for Payer: Cigna Commercial |
$122.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.29
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$53.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.49
|
|
|
CATH RBU LAUNCHER 6FR 3.5
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636781
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$59.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.29
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$53.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
|
|
CATH RBU LAUNCHER 6FR 4.0
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636782C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
CATH RBU LAUNCHER 6FR 4.0
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636782N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
CATH RBU LAUNCHER 6FR 4.0
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636782N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$247.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
CATH RBU LAUNCHER 6FR 4.0
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636782C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.96
|
|
|
CATH RBU LNCH 6FR 3 LA6RBU3.5
|
Facility
|
OP
|
$650.00
|
|
| Hospital Charge Code |
270636781C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$247.00
|
| Rate for Payer: Aetna Medicare Advantage |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.75
|
| Rate for Payer: Cigna Commercial |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
CATH RBU LNCH 6FR 3 LA6RBU3.5
|
Facility
|
IP
|
$650.00
|
|
| Hospital Charge Code |
270636781C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|
|
CATH RED RUBBER UTILITY 10FR
|
Facility
|
OP
|
$1.70
|
|
| Hospital Charge Code |
270649057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Aetna Commercial |
$0.65
|
| Rate for Payer: Aetna Medicare Advantage |
$0.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.43
|
| Rate for Payer: Cigna Commercial |
$0.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.51
|
| Rate for Payer: Oxford Commercial |
$0.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.34
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.05
|
|
|
CATH RED RUBBER UTILITY 10FR
|
Facility
|
IP
|
$1.70
|
|
| Hospital Charge Code |
270649057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.26
|
|
|
CATH RED RUBBER UTILITY 12FR
|
Facility
|
IP
|
$2.70
|
|
| Hospital Charge Code |
270649058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.41
|
|
|
CATH RED RUBBER UTILITY 12FR
|
Facility
|
OP
|
$2.70
|
|
| Hospital Charge Code |
270649058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Aetna Commercial |
$1.03
|
| Rate for Payer: Aetna Medicare Advantage |
$0.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.69
|
| Rate for Payer: Cigna Commercial |
$1.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.81
|
| Rate for Payer: Oxford Commercial |
$0.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.07
|
|
|
CATH REENT 2 7X20 ENB27520150
|
Facility
|
IP
|
$12,475.00
|
|
| Hospital Charge Code |
270664081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,871.25 |
| Max. Negotiated Rate |
$3,018.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,495.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,018.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,744.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,871.25
|
|
|
CATH REENT 2 7X20 ENB27520150
|
Facility
|
OP
|
$12,475.00
|
|
| Hospital Charge Code |
270664081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$300.65 |
| Max. Negotiated Rate |
$6,237.50 |
| Rate for Payer: Aetna Commercial |
$4,740.50
|
| Rate for Payer: Aetna Medicare Advantage |
$3,742.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,181.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,181.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,181.12
|
| Rate for Payer: Cigna Commercial |
$6,237.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,018.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,744.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,871.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$330.59
|
|
|
CATH REENTRY 3 7MMx20MMx135CM
|
Facility
|
OP
|
$13,975.00
|
|
| Hospital Charge Code |
270660085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$336.80 |
| Max. Negotiated Rate |
$6,987.50 |
| Rate for Payer: Aetna Commercial |
$5,310.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,192.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,563.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,563.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,563.62
|
| Rate for Payer: Cigna Commercial |
$6,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,192.50
|
| Rate for Payer: Oxford Commercial |
$2,795.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,096.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,795.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$336.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$370.34
|
|