|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
366836140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
321036140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
411036140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
7411422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
7411422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
411036140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDL/CATH EXTR ART
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
366836140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NDLE/CATH AV SHUNT
|
Facility
|
IP
|
$414.45
|
|
| Hospital Charge Code |
2004745
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDLE/CATH AV SHUNT
|
Facility
|
OP
|
$414.45
|
|
| Hospital Charge Code |
2004745
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$207.22 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$82.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$82.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NDLE/CATH AV SNT ADDI
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36148
|
| Hospital Charge Code |
5600192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDLE/CATH AV SNT ADDI
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36148
|
| Hospital Charge Code |
5600192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NDLE/CATH AV SNT ADDI
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36148
|
| Hospital Charge Code |
7411424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NDLE/CATH AV SNT ADDI
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36148
|
| Hospital Charge Code |
7411424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NDLE/CATH AV SNT INIT
|
Facility
|
IP
|
$1,310.20
|
|
|
Service Code
|
HCPCS 36147
|
| Hospital Charge Code |
7411423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.53 |
| Max. Negotiated Rate |
$196.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$196.53
|
|
|
IR INTRO NDLE/CATH AV SNT INIT
|
Facility
|
OP
|
$1,310.20
|
|
|
Service Code
|
HCPCS 36147
|
| Hospital Charge Code |
7411423
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$31.58 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$497.88
|
| Rate for Payer: Aetna Medicare Advantage |
$393.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$334.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$334.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$334.10
|
| Rate for Payer: Cigna Commercial |
$655.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$196.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.72
|
|
|
IR INTRO NDLE/CATH AV SNT INIT
|
Facility
|
OP
|
$1,310.20
|
|
|
Service Code
|
HCPCS 36147
|
| Hospital Charge Code |
5600191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$31.58 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$497.88
|
| Rate for Payer: Aetna Medicare Advantage |
$393.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$334.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$334.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$334.10
|
| Rate for Payer: Cigna Commercial |
$655.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$196.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.72
|
|
|
IR INTRO NDLE/CATH AV SNT INIT
|
Facility
|
IP
|
$1,310.20
|
|
|
Service Code
|
HCPCS 36147
|
| Hospital Charge Code |
5600191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.53 |
| Max. Negotiated Rate |
$196.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$196.53
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
2001345
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
IP
|
$1,780.85
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
411036160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.13 |
| Max. Negotiated Rate |
$267.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$267.13
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
IP
|
$1,780.45
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
366836160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.07 |
| Max. Negotiated Rate |
$267.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$267.07
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
OP
|
$1,780.85
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
411036160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$676.72
|
| Rate for Payer: Aetna Medicare Advantage |
$534.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$454.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$454.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$454.12
|
| Rate for Payer: Cigna Commercial |
$890.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$534.25
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$267.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$42.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.19
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
321036160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
2001345
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
321036160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR INTRO NEEDLE AORTA TRNSLUMB
|
Facility
|
IP
|
$1,780.85
|
|
|
Service Code
|
HCPCS 36160
|
| Hospital Charge Code |
7411425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.13 |
| Max. Negotiated Rate |
$267.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$267.13
|
|
