|
INTRODUCER CRD HEM 5F 504-605X
|
Facility
|
OP
|
$238.75
|
|
| Hospital Charge Code |
270617154
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$119.38 |
| Rate for Payer: Aetna Commercial |
$90.72
|
| Rate for Payer: Aetna Medicare Advantage |
$71.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.88
|
| Rate for Payer: Cigna Commercial |
$119.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.62
|
| Rate for Payer: Oxford Commercial |
$47.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.33
|
|
|
INTRODUCER CRD HEM 5F 504-605X
|
Facility
|
IP
|
$238.75
|
|
| Hospital Charge Code |
270617154
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$35.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.81
|
|
|
INTRODUCER FLEX 14FR ALL PURPO
|
Facility
|
OP
|
$359.45
|
|
| Hospital Charge Code |
2709006115
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$179.72 |
| Rate for Payer: Aetna Commercial |
$136.59
|
| Rate for Payer: Aetna Medicare Advantage |
$107.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.66
|
| Rate for Payer: Cigna Commercial |
$179.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$107.83
|
| Rate for Payer: Oxford Commercial |
$71.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$71.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.53
|
|
|
INTRODUCER FLEX 14FR ALL PURPO
|
Facility
|
IP
|
$359.45
|
|
| Hospital Charge Code |
2709006115
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.92 |
| Max. Negotiated Rate |
$53.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.92
|
|
|
INTRODUCER FLEXOR SIDEARM 6FR
|
Facility
|
OP
|
$775.00
|
|
| Hospital Charge Code |
270636222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$387.50 |
| Rate for Payer: Aetna Commercial |
$294.50
|
| Rate for Payer: Aetna Medicare Advantage |
$232.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$197.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$197.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$197.62
|
| Rate for Payer: Cigna Commercial |
$387.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$232.50
|
| Rate for Payer: Oxford Commercial |
$155.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$155.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.54
|
|
|
INTRODUCER FLEXOR SIDEARM 6FR
|
Facility
|
IP
|
$775.00
|
|
| Hospital Charge Code |
270636222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.25 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.25
|
|
|
INTRODUCER GUIDESHEATH 5FRX10
|
Facility
|
IP
|
$247.50
|
|
| Hospital Charge Code |
2709004260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|
|
INTRODUCER GUIDESHEATH 5FRX10
|
Facility
|
OP
|
$247.50
|
|
| Hospital Charge Code |
2709004260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$94.05
|
| Rate for Payer: Aetna Medicare Advantage |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.11
|
| Rate for Payer: Cigna Commercial |
$123.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.25
|
| Rate for Payer: Oxford Commercial |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.56
|
|
|
INTRODUCER GUIDESHEATH 5FRX25
|
Facility
|
OP
|
$250.00
|
|
| Hospital Charge Code |
2709004266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$95.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.00
|
| Rate for Payer: Oxford Commercial |
$50.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.62
|
|
|
INTRODUCER GUIDESHEATH 5FRX25
|
Facility
|
IP
|
$250.00
|
|
| Hospital Charge Code |
2709004266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
INTRODUCER GUIDESHEATH 6FRX10
|
Facility
|
IP
|
$247.50
|
|
| Hospital Charge Code |
2709004261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|
|
INTRODUCER GUIDESHEATH 6FRX10
|
Facility
|
OP
|
$247.50
|
|
| Hospital Charge Code |
2709004261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$94.05
|
| Rate for Payer: Aetna Medicare Advantage |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.11
|
| Rate for Payer: Cigna Commercial |
$123.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.25
|
| Rate for Payer: Oxford Commercial |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.56
|
|
|
INTRODUCER KIT MIC JTJ18 98436
|
Facility
|
IP
|
$996.85
|
|
| Hospital Charge Code |
270672028
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.53 |
| Max. Negotiated Rate |
$149.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.53
|
|
|
INTRODUCER KIT MIC JTJ18 98436
|
Facility
|
IP
|
$997.50
|
|
| Hospital Charge Code |
270672028N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.62 |
| Max. Negotiated Rate |
$149.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.62
|
|
|
INTRODUCER KIT MIC JTJ18 98436
|
Facility
|
OP
|
$996.85
|
|
| Hospital Charge Code |
270672028
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.02 |
| Max. Negotiated Rate |
$498.43 |
| Rate for Payer: Aetna Commercial |
$378.80
|
| Rate for Payer: Aetna Medicare Advantage |
$299.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.20
|
| Rate for Payer: Cigna Commercial |
$498.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$299.06
|
| Rate for Payer: Oxford Commercial |
$199.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$199.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.42
|
|
|
INTRODUCER KIT MIC JTJ18 98436
|
Facility
|
IP
|
$996.85
|
|
| Hospital Charge Code |
270672028S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.53 |
| Max. Negotiated Rate |
$149.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.53
|
|
|
INTRODUCER KIT MIC JTJ18 98436
|
Facility
|
OP
|
$996.85
|
|
| Hospital Charge Code |
270672028S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.02 |
| Max. Negotiated Rate |
$498.43 |
| Rate for Payer: Aetna Commercial |
$378.80
|
| Rate for Payer: Aetna Medicare Advantage |
$299.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.20
|
| Rate for Payer: Cigna Commercial |
$498.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$299.06
|
| Rate for Payer: Oxford Commercial |
$199.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$199.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.42
|
|
|
INTRODUCER KIT MIC JTJ18 98436
|
Facility
|
OP
|
$997.50
|
|
| Hospital Charge Code |
270672028N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.04 |
| Max. Negotiated Rate |
$498.75 |
| Rate for Payer: Aetna Commercial |
$379.05
|
| Rate for Payer: Aetna Medicare Advantage |
$299.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.36
|
| Rate for Payer: Cigna Commercial |
$498.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$299.25
|
| Rate for Payer: Oxford Commercial |
$199.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$199.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.43
|
|
|
INTRODUCER KIT MIC-KEY G-18
|
Facility
|
OP
|
$973.10
|
|
| Hospital Charge Code |
270677676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.45 |
| Max. Negotiated Rate |
$486.55 |
| Rate for Payer: Aetna Commercial |
$369.78
|
| Rate for Payer: Aetna Medicare Advantage |
$291.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.14
|
| Rate for Payer: Cigna Commercial |
$486.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$291.93
|
| Rate for Payer: Oxford Commercial |
$194.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$194.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.79
|
|
|
INTRODUCER KIT MIC-KEY G-18
|
Facility
|
IP
|
$973.10
|
|
| Hospital Charge Code |
270677676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.97 |
| Max. Negotiated Rate |
$145.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.97
|
|
|
INTRODUCER KIT MIG-KEY G-18
|
Facility
|
OP
|
$973.10
|
|
| Hospital Charge Code |
270677676N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.45 |
| Max. Negotiated Rate |
$486.55 |
| Rate for Payer: Aetna Commercial |
$369.78
|
| Rate for Payer: Aetna Medicare Advantage |
$291.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.14
|
| Rate for Payer: Cigna Commercial |
$486.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$291.93
|
| Rate for Payer: Oxford Commercial |
$194.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$194.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.79
|
|
|
INTRODUCER KIT MIG-KEY G-18
|
Facility
|
IP
|
$973.10
|
|
| Hospital Charge Code |
270677676S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.97 |
| Max. Negotiated Rate |
$145.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.97
|
|
|
INTRODUCER KIT MIG-KEY G-18
|
Facility
|
IP
|
$973.10
|
|
| Hospital Charge Code |
270677676N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.97 |
| Max. Negotiated Rate |
$145.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.97
|
|
|
INTRODUCER KIT MIG-KEY G-18
|
Facility
|
OP
|
$973.10
|
|
| Hospital Charge Code |
270677676S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.45 |
| Max. Negotiated Rate |
$486.55 |
| Rate for Payer: Aetna Commercial |
$369.78
|
| Rate for Payer: Aetna Medicare Advantage |
$291.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.14
|
| Rate for Payer: Cigna Commercial |
$486.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$291.93
|
| Rate for Payer: Oxford Commercial |
$194.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$194.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.79
|
|
|
INTRODUCER KIT PERCUTANEOUS
|
Facility
|
OP
|
$450.00
|
|
| Hospital Charge Code |
270660590
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare Advantage |
$135.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$114.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$114.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$114.75
|
| Rate for Payer: Cigna Commercial |
$225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.00
|
| Rate for Payer: Oxford Commercial |
$90.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.93
|
|
