|
PACEMAKER MEDT 8424
|
Facility
|
OP
|
$16,531.25
|
|
| Hospital Charge Code |
270602720
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$398.40 |
| Max. Negotiated Rate |
$8,265.62 |
| Rate for Payer: Aetna Commercial |
$6,281.88
|
| Rate for Payer: Aetna Medicare Advantage |
$4,959.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,215.47
|
| Rate for Payer: Cigna Commercial |
$8,265.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$398.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.08
|
|
|
PACEMAKER MEDT 8426
|
Facility
|
OP
|
$16,531.25
|
|
| Hospital Charge Code |
270602721
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$398.40 |
| Max. Negotiated Rate |
$8,265.62 |
| Rate for Payer: Aetna Commercial |
$6,281.88
|
| Rate for Payer: Aetna Medicare Advantage |
$4,959.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,215.47
|
| Rate for Payer: Cigna Commercial |
$8,265.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$398.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.08
|
|
|
PACEMAKER MEDT 8426
|
Facility
|
IP
|
$16,531.25
|
|
| Hospital Charge Code |
270602721
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,479.69 |
| Max. Negotiated Rate |
$4,000.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
|
|
PACEMAKER MEDT 8427
|
Facility
|
OP
|
$16,531.25
|
|
| Hospital Charge Code |
270602722
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$398.40 |
| Max. Negotiated Rate |
$8,265.62 |
| Rate for Payer: Aetna Commercial |
$6,281.88
|
| Rate for Payer: Aetna Medicare Advantage |
$4,959.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,215.47
|
| Rate for Payer: Cigna Commercial |
$8,265.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$398.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.08
|
|
|
PACEMAKER MEDT 8427
|
Facility
|
IP
|
$16,531.25
|
|
| Hospital Charge Code |
270602722
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,479.69 |
| Max. Negotiated Rate |
$4,000.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
|
|
PACEMAKER MEDT 8491
|
Facility
|
OP
|
$16,531.25
|
|
| Hospital Charge Code |
270602726
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$398.40 |
| Max. Negotiated Rate |
$8,265.62 |
| Rate for Payer: Aetna Commercial |
$6,281.88
|
| Rate for Payer: Aetna Medicare Advantage |
$4,959.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,215.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,215.47
|
| Rate for Payer: Cigna Commercial |
$8,265.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$398.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.08
|
|
|
PACEMAKER MEDT 8491
|
Facility
|
IP
|
$16,531.25
|
|
| Hospital Charge Code |
270602726
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,479.69 |
| Max. Negotiated Rate |
$4,000.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,306.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,000.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,636.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,479.69
|
|
|
PACEMAKER MEDT 8940B
|
Facility
|
IP
|
$17,337.65
|
|
| Hospital Charge Code |
270602716
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,600.65 |
| Max. Negotiated Rate |
$4,195.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
|
|
PACEMAKER MEDT 8940B
|
Facility
|
OP
|
$17,337.65
|
|
| Hospital Charge Code |
270602716
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$417.84 |
| Max. Negotiated Rate |
$8,668.83 |
| Rate for Payer: Aetna Commercial |
$6,588.31
|
| Rate for Payer: Aetna Medicare Advantage |
$5,201.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,421.10
|
| Rate for Payer: Cigna Commercial |
$8,668.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$417.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$459.45
|
|
|
PACEMAKER MEDT 8940U
|
Facility
|
IP
|
$17,337.65
|
|
| Hospital Charge Code |
270602717
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,600.65 |
| Max. Negotiated Rate |
$4,195.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
|
|
PACEMAKER MEDT 8940U
|
Facility
|
OP
|
$17,337.65
|
|
| Hospital Charge Code |
270602717
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$417.84 |
| Max. Negotiated Rate |
$8,668.83 |
| Rate for Payer: Aetna Commercial |
$6,588.31
|
| Rate for Payer: Aetna Medicare Advantage |
$5,201.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,421.10
|
| Rate for Payer: Cigna Commercial |
$8,668.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$417.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$459.45
|
|
|
PACEMAKER MEDT 8941
|
Facility
|
OP
|
$17,337.65
|
|
| Hospital Charge Code |
270602718
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$417.84 |
| Max. Negotiated Rate |
$8,668.83 |
| Rate for Payer: Aetna Commercial |
$6,588.31
|
| Rate for Payer: Aetna Medicare Advantage |
$5,201.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,421.10
|
| Rate for Payer: Cigna Commercial |
$8,668.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$417.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$459.45
|
|
|
PACEMAKER MEDT 8941
|
Facility
|
IP
|
$17,337.65
|
|
| Hospital Charge Code |
270602718
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,600.65 |
| Max. Negotiated Rate |
$4,195.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
|
|
PACEMAKER MEDT 8942
|
Facility
|
OP
|
$17,337.65
|
|
| Hospital Charge Code |
270602719
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$417.84 |
| Max. Negotiated Rate |
$8,668.83 |
| Rate for Payer: Aetna Commercial |
$6,588.31
|
| Rate for Payer: Aetna Medicare Advantage |
$5,201.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,421.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,421.10
|
| Rate for Payer: Cigna Commercial |
$8,668.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$417.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$459.45
|
|
|
PACEMAKER MEDT 8942
|
Facility
|
IP
|
$17,337.65
|
|
| Hospital Charge Code |
270602719
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,600.65 |
| Max. Negotiated Rate |
$4,195.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,467.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,814.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,600.65
|
|
|
PACEMAKER MEDT 8944B
|
Facility
|
OP
|
$14,515.25
|
|
| Hospital Charge Code |
270602731
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$349.82 |
| Max. Negotiated Rate |
$7,257.62 |
| Rate for Payer: Aetna Commercial |
$5,515.80
|
| Rate for Payer: Aetna Medicare Advantage |
$4,354.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,701.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,701.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,903.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,701.39
|
| Rate for Payer: Cigna Commercial |
$7,257.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,512.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,193.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,177.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$349.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$384.65
|
|
|
PACEMAKER MEDT 8944B
|
Facility
|
IP
|
$14,515.25
|
|
| Hospital Charge Code |
270602731
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,177.29 |
| Max. Negotiated Rate |
$3,512.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,903.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,512.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,193.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,177.29
|
|
|
PACEMAKER MEDT 8944U
|
Facility
|
OP
|
$14,515.25
|
|
| Hospital Charge Code |
270602732
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$349.82 |
| Max. Negotiated Rate |
$7,257.62 |
| Rate for Payer: Aetna Commercial |
$5,515.80
|
| Rate for Payer: Aetna Medicare Advantage |
$4,354.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,701.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,701.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,903.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,701.39
|
| Rate for Payer: Cigna Commercial |
$7,257.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,512.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,193.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,177.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$349.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$384.65
|
|
|
PACEMAKER MEDT 8944U
|
Facility
|
IP
|
$14,515.25
|
|
| Hospital Charge Code |
270602732
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,177.29 |
| Max. Negotiated Rate |
$3,512.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,903.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,512.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,193.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,177.29
|
|
|
PACEMAKER MEDT 8945
|
Facility
|
OP
|
$14,515.25
|
|
| Hospital Charge Code |
270602733
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$349.82 |
| Max. Negotiated Rate |
$7,257.62 |
| Rate for Payer: Aetna Commercial |
$5,515.80
|
| Rate for Payer: Aetna Medicare Advantage |
$4,354.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,701.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,701.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,903.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,701.39
|
| Rate for Payer: Cigna Commercial |
$7,257.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,512.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,193.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,177.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$349.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$384.65
|
|
|
PACEMAKER MEDT 8945
|
Facility
|
IP
|
$14,515.25
|
|
| Hospital Charge Code |
270602733
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,177.29 |
| Max. Negotiated Rate |
$3,512.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,903.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,512.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,193.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,177.29
|
|
|
PACEMAKER MEDT 8960iB
|
Facility
|
OP
|
$20,160.00
|
|
| Hospital Charge Code |
270602712C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$485.86 |
| Max. Negotiated Rate |
$10,080.00 |
| Rate for Payer: Aetna Commercial |
$7,660.80
|
| Rate for Payer: Aetna Medicare Advantage |
$6,048.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,140.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,140.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,032.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,140.80
|
| Rate for Payer: Cigna Commercial |
$10,080.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,878.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,435.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,024.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$485.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$534.24
|
|
|
PACEMAKER MEDT 8960iB
|
Facility
|
IP
|
$20,160.00
|
|
| Hospital Charge Code |
270602712C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,024.00 |
| Max. Negotiated Rate |
$4,878.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,032.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,878.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,435.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,024.00
|
|
|
PACEMAKER MEDT 8960iB
|
Facility
|
OP
|
$20,160.00
|
|
| Hospital Charge Code |
270602712
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$485.86 |
| Max. Negotiated Rate |
$10,080.00 |
| Rate for Payer: Aetna Commercial |
$7,660.80
|
| Rate for Payer: Aetna Medicare Advantage |
$6,048.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,140.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,140.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,032.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,140.80
|
| Rate for Payer: Cigna Commercial |
$10,080.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,878.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,435.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,024.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$485.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$534.24
|
|
|
PACEMAKER MEDT 8960iB
|
Facility
|
IP
|
$20,160.00
|
|
| Hospital Charge Code |
270602712
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,024.00 |
| Max. Negotiated Rate |
$4,878.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,032.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,878.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,435.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,024.00
|
|