|
CATH WH II 6X2X75 PTA 16500410
|
Facility
|
IP
|
$1,116.00
|
|
| Hospital Charge Code |
270635678
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.40 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.40
|
|
|
CATH WH II 6X2X75 PTA 16500410
|
Facility
|
OP
|
$1,116.00
|
|
| Hospital Charge Code |
270635678
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$558.00 |
| Rate for Payer: Aetna Commercial |
$424.08
|
| Rate for Payer: Aetna Medicare Advantage |
$334.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$284.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$284.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$284.58
|
| Rate for Payer: Cigna Commercial |
$558.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$334.80
|
| Rate for Payer: Oxford Commercial |
$223.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$223.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.57
|
|
|
CATH WILDCAT GW SUPPORT 5FR
|
Facility
|
OP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270647588N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCAT GW SUPPORT 5FR
|
Facility
|
IP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270647588
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCAT GW SUPPORT 5FR
|
Facility
|
OP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270647588
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCAT GW SUPPORT 5FR
|
Facility
|
IP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270647588N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCAT GW SUPPORT 6FR
|
Facility
|
OP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270644955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCAT GW SUPPORT 6FR
|
Facility
|
IP
|
$6,975.00
|
|
| Hospital Charge Code |
270644955C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,046.25 |
| Max. Negotiated Rate |
$1,687.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,534.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
|
|
CATH WILDCAT GW SUPPORT 6FR
|
Facility
|
IP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270644955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCAT GW SUPPORT 6FR
|
Facility
|
OP
|
$6,975.00
|
|
| Hospital Charge Code |
270644955C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.10 |
| Max. Negotiated Rate |
$3,487.50 |
| Rate for Payer: Aetna Commercial |
$2,650.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,092.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,778.62
|
| Rate for Payer: Cigna Commercial |
$3,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,534.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$168.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$184.84
|
|
|
CATH WILDCAT GW SUPPORT 6FR W/
|
Facility
|
IP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270646591C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCAT GW SUPPORT 6FR W/
|
Facility
|
IP
|
$7,975.00
|
|
| Hospital Charge Code |
270646291
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCAT GW SUPPORT 6FR W/
|
Facility
|
OP
|
$7,975.00
|
|
| Hospital Charge Code |
270646291
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCAT GW SUPPORT 6FR W/
|
Facility
|
IP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270646591N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCAT GW SUPPORT 6FR W/
|
Facility
|
OP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270646591C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCAT GW SUPPORT 6FR W/
|
Facility
|
OP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270646591N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCATH GW SUPPORT 5FR
|
Facility
|
IP
|
$6,975.00
|
|
| Hospital Charge Code |
270645073C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,046.25 |
| Max. Negotiated Rate |
$1,687.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,534.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
|
|
CATH WILDCATH GW SUPPORT 5FR
|
Facility
|
IP
|
$7,975.00
|
|
| Hospital Charge Code |
27067588
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCATH GW SUPPORT 5FR
|
Facility
|
OP
|
$7,975.00
|
|
| Hospital Charge Code |
27067588
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCATH GW SUPPORT 5FR
|
Facility
|
IP
|
$7,975.00
|
|
| Hospital Charge Code |
270647588C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
CATH WILDCATH GW SUPPORT 5FR
|
Facility
|
OP
|
$7,975.00
|
|
| Hospital Charge Code |
270647588C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.20 |
| Max. Negotiated Rate |
$3,987.50 |
| Rate for Payer: Aetna Commercial |
$3,030.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,392.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,033.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,033.62
|
| Rate for Payer: Cigna Commercial |
$3,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,754.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.34
|
|
|
CATH WILDCATH GW SUPPORT 5FR
|
Facility
|
OP
|
$6,975.00
|
|
| Hospital Charge Code |
270645073C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.10 |
| Max. Negotiated Rate |
$3,487.50 |
| Rate for Payer: Aetna Commercial |
$2,650.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,092.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,778.62
|
| Rate for Payer: Cigna Commercial |
$3,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,534.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$168.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$184.84
|
|
|
CATH WILLSOGLES PREC GAS 140F
|
Facility
|
IP
|
$800.35
|
|
| Hospital Charge Code |
270658330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.05 |
| Max. Negotiated Rate |
$120.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.05
|
|
|
CATH WILLSOGLES PREC GAS 140F
|
Facility
|
OP
|
$800.35
|
|
| Hospital Charge Code |
270658330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$400.18 |
| Rate for Payer: Aetna Commercial |
$304.13
|
| Rate for Payer: Aetna Medicare Advantage |
$240.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.09
|
| Rate for Payer: Cigna Commercial |
$400.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.10
|
| Rate for Payer: Oxford Commercial |
$160.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$160.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.21
|
|
|
CATH WINGMAN CROSS.014C150 3F
|
Facility
|
IP
|
$4,975.00
|
|
| Hospital Charge Code |
270705363
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$746.25 |
| Max. Negotiated Rate |
$746.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$746.25
|
|
