|
GUIDE CATH JL 4.0 6F
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
2709001176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.00
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.42
|
|
|
GUIDE CATH JL 4.0 6F SH
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709001177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH JL 4.0 6F SH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709001177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$104.41
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.42
|
| Rate for Payer: Oxford Commercial |
$54.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$54.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.28
|
|
|
GUIDE CATH JL 4.0 SH 6F
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636295
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$52.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.36
|
|
|
GUIDE CATH JL 4.0 SH 6F
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636295
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$52.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
GUIDE CATH JR 3.56F
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709001193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$104.41
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.42
|
| Rate for Payer: Oxford Commercial |
$54.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$54.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.28
|
|
|
GUIDE CATH JR 3.56F
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709001193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH JR 4.0 6F SH
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
2709001195
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.00
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.42
|
|
|
GUIDE CATH JR 4.0 6F SH
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
2709001195
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|
|
GUIDE CATH JR 4.0 SH 7FR
|
Facility
|
IP
|
$54.95
|
|
| Hospital Charge Code |
270636357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$12.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.24
|
|
|
GUIDE CATH JR 4.0 SH 7FR
|
Facility
|
OP
|
$54.95
|
|
| Hospital Charge Code |
270636357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$27.48 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Medicare Advantage |
$16.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.01
|
| Rate for Payer: Cigna Commercial |
$27.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$12.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.24
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.46
|
|
|
GUIDE CATH LCB 6F
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
2709001208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.00
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.42
|
|
|
GUIDE CATH LCB 6F
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
2709001208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|
|
GUIDE CATH WILLIAMS RT 6FRx100
|
Facility
|
IP
|
$255.00
|
|
| Hospital Charge Code |
270646209C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$61.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$56.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
|
|
GUIDE CATH WILLIAMS RT 6FRx100
|
Facility
|
OP
|
$255.00
|
|
| Hospital Charge Code |
270646209C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.15 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Medicare Advantage |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.03
|
| Rate for Payer: Cigna Commercial |
$127.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$56.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.76
|
|
|
GUIDE CATH XB 3.0 6F
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
2709001182
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.00
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.42
|
|
|
GUIDE CATH XB 3.0 6F
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
2709001182
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|
|
GUIDE CATH XB 3.5 6F SH
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709001185
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH XB 3.5 6F SH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709001185
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$104.41
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.42
|
| Rate for Payer: Oxford Commercial |
$54.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$54.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.28
|
|
|
GUIDE CATH XB 3.5 SH 6F
|
Facility
|
OP
|
$54.95
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636335N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$27.48 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Medicare Advantage |
$16.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.01
|
| Rate for Payer: Cigna Commercial |
$27.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$12.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.24
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.46
|
|
|
GUIDE CATH XB 3.5 SH 6F
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636335
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$52.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
GUIDE CATH XB 3.5 SH 6F
|
Facility
|
IP
|
$54.95
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636335N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$12.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.24
|
|
|
GUIDE CATH XB 3.5 SH 6F
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636335
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$52.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.36
|
|
|
GUIDE CATH XB 4.0 6F
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
2709001188
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.00
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.42
|
|
|
GUIDE CATH XB 4.0 6F
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
2709001188
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|