|
MARDIS URETERAL STENT 6FRX24CM
|
Facility
|
IP
|
$955.00
|
|
| Hospital Charge Code |
270332071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.25 |
| Max. Negotiated Rate |
$231.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$191.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$231.11
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$210.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
|
|
MARDIS URETERAL STENT 6FRX24CM
|
Facility
|
OP
|
$955.00
|
|
| Hospital Charge Code |
270332071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.02 |
| Max. Negotiated Rate |
$477.50 |
| Rate for Payer: Aetna Commercial |
$362.90
|
| Rate for Payer: Aetna Medicare Advantage |
$286.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$243.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$243.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$191.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$243.53
|
| Rate for Payer: Cigna Commercial |
$477.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$231.11
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$210.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.31
|
|
|
MARIJUANA
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
38472476
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.60
|
|
|
MARIJUANA
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
38472476
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Aetna Commercial |
$123.12
|
| Rate for Payer: Aetna Medicare Advantage |
$97.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.62
|
| Rate for Payer: Cigna Commercial |
$162.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.59
|
|
|
MARIJUANA CONFIRMATION
|
Facility
|
IP
|
$124.10
|
|
|
Service Code
|
HCPCS 82542
|
| Hospital Charge Code |
39900068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.61 |
| Max. Negotiated Rate |
$18.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.61
|
|
|
MARIJUANA CONFIRMATION
|
Facility
|
OP
|
$124.10
|
|
|
Service Code
|
HCPCS 82542
|
| Hospital Charge Code |
39900068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$65.52
|
| Rate for Payer: Aetna Medicare Advantage |
$78.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.96
|
| Rate for Payer: Cigna Commercial |
$62.05
|
| Rate for Payer: Cigna Medicare Advantage |
$24.09
|
| Rate for Payer: Clover Medicare Advantage |
$22.89
|
| Rate for Payer: EmblemHealth Commercial |
$72.27
|
| Rate for Payer: Humana Medicare Advantage |
$24.81
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.23
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.29
|
|
|
MARINOL 2.5MG CAP
|
Facility
|
IP
|
$29.00
|
|
| Hospital Charge Code |
60635608
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$4.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.35
|
|
|
MARINOL 2.5MG CAP
|
Facility
|
OP
|
$29.00
|
|
| Hospital Charge Code |
60635608
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$14.50 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: Aetna Medicare Advantage |
$8.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.39
|
| Rate for Payer: Cigna Commercial |
$14.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.70
|
| Rate for Payer: Oxford Commercial |
$5.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.77
|
|
|
MARKER BREAST BX TUMARK-Q
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669923R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare Advantage |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.62
|
| Rate for Payer: Cigna Commercial |
$187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$82.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.94
|
|
|
MARKER BREAST BX TUMARK-Q
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669923R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.25 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$75.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$82.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
|
|
MARKER BREAST BX TUMARK-Q
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669923
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare Advantage |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.62
|
| Rate for Payer: Cigna Commercial |
$187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$82.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.94
|
|
|
MARKER BREAST BX TUMARK-Q
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270669923
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.25 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$75.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$82.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
|
|
MARKER BREAST MAMMOMARK2 8 MR
|
Facility
|
OP
|
$482.00
|
|
| Hospital Charge Code |
270646288
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.62 |
| Max. Negotiated Rate |
$241.00 |
| Rate for Payer: Aetna Commercial |
$183.16
|
| Rate for Payer: Aetna Medicare Advantage |
$144.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$122.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$122.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$122.91
|
| Rate for Payer: Cigna Commercial |
$241.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.60
|
| Rate for Payer: Oxford Commercial |
$96.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$96.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.77
|
|
|
MARKER BREAST MAMMOMARK2 8 MR
|
Facility
|
IP
|
$482.00
|
|
| Hospital Charge Code |
270646288
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$72.30 |
| Max. Negotiated Rate |
$72.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.30
|
|
|
MARKER BX BREAST SMARKMSS1
|
Facility
|
OP
|
$403.75
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270664833R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$201.88 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna Medicare Advantage |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.96
|
| Rate for Payer: Cigna Commercial |
$201.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$88.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.70
|
|
|
MARKER BX BREAST SMARKMSS1
|
Facility
|
IP
|
$403.75
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270664833R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.56 |
| Max. Negotiated Rate |
$97.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$88.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.56
|
|
|
MARKERBXEVIVASMARKSHAPE1 13MM
|
Facility
|
OP
|
$359.15
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270675352R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$179.57 |
| Rate for Payer: Aetna Commercial |
$136.48
|
| Rate for Payer: Aetna Medicare Advantage |
$107.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.58
|
| Rate for Payer: Cigna Commercial |
$179.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.91
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$79.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.87
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.52
|
|
|
MARKERBXEVIVASMARKSHAPE1 13MM
|
Facility
|
IP
|
$359.15
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270675352R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.87 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.91
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$79.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.87
|
|
|
MARKER BX SITE TRIMMEK
|
Facility
|
IP
|
$3,800.00
|
|
| Hospital Charge Code |
270664834
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$570.00 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$570.00
|
|
|
MARKER BX SITE TRIMMEK
|
Facility
|
OP
|
$3,800.00
|
|
| Hospital Charge Code |
270664834
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$91.58 |
| Max. Negotiated Rate |
$1,900.00 |
| Rate for Payer: Aetna Commercial |
$1,444.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$969.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$969.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,140.00
|
| Rate for Payer: Oxford Commercial |
$760.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$570.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$91.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$100.70
|
|
|
MARKER BX SMARK EVIVA 3RD SH
|
Facility
|
IP
|
$403.75
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270675459R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.56 |
| Max. Negotiated Rate |
$97.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$88.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.56
|
|
|
MARKER BX SMARK EVIVA 3RD SH
|
Facility
|
OP
|
$403.75
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270675459R
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$201.88 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna Medicare Advantage |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.96
|
| Rate for Payer: Cigna Commercial |
$201.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$88.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.70
|
|
|
MARKER BX TI SMARK-CELERO-12
|
Facility
|
OP
|
$412.25
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270697947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$206.12 |
| Rate for Payer: Aetna Commercial |
$156.66
|
| Rate for Payer: Aetna Medicare Advantage |
$123.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$82.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.12
|
| Rate for Payer: Cigna Commercial |
$206.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.76
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$90.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.84
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.92
|
|
|
MARKER BX TI SMARK-CELERO-12
|
Facility
|
IP
|
$412.25
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270697947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$61.84 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$82.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.76
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$90.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.84
|
|
|
MARKERBXTITOPHATSMARKCELER122S
|
Facility
|
IP
|
$412.25
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
270697948
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$61.84 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$82.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.76
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$90.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.84
|
|