|
STENT EXPRESS 7x27 3804773013
|
Facility
|
OP
|
$6,975.00
|
|
| Hospital Charge Code |
270634365V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.10 |
| Max. Negotiated Rate |
$3,487.50 |
| Rate for Payer: Aetna Commercial |
$2,650.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,092.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,778.62
|
| Rate for Payer: Cigna Commercial |
$3,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,534.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$168.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$184.84
|
|
|
STENT EXPRESS 7x27 3804773013
|
Facility
|
IP
|
$6,975.00
|
|
| Hospital Charge Code |
270634365V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,046.25 |
| Max. Negotiated Rate |
$1,687.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,534.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
|
|
STENT EXPRESS 8x27 135cm
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270634366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS 8x27 135cm
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270634366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS 8x27 3804783013
|
Facility
|
IP
|
$6,919.25
|
|
| Hospital Charge Code |
270634366V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,037.89 |
| Max. Negotiated Rate |
$1,674.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,383.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,674.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,522.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,037.89
|
|
|
STENT EXPRESS 8x27 3804783013
|
Facility
|
OP
|
$6,919.25
|
|
| Hospital Charge Code |
270634366V
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.75 |
| Max. Negotiated Rate |
$3,459.62 |
| Rate for Payer: Aetna Commercial |
$2,629.32
|
| Rate for Payer: Aetna Medicare Advantage |
$2,075.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,764.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,764.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,383.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,764.41
|
| Rate for Payer: Cigna Commercial |
$3,459.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,674.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,522.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,037.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$166.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$183.36
|
|
|
STENT EXPRESS 8x37 135cm
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270634114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS 8x37 135cm
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270634114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS 8x37 75cm
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270628305
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS 8x37 75cm
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270628305
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS 8x57 75cm
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270630484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS 8x57 75cm
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270630484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS 9x37 135cm
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270636468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS 9x37 135cm
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270636468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS 9x37 75cm
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270633222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS 9x37 75cm
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270633222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
IP
|
$5,942.30
|
|
| Hospital Charge Code |
270653631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
IP
|
$5,957.00
|
|
| Hospital Charge Code |
270CH0078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$893.55 |
| Max. Negotiated Rate |
$1,441.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,191.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,441.59
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,310.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$893.55
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
IP
|
$6,417.00
|
|
| Hospital Charge Code |
270CH0079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$962.55 |
| Max. Negotiated Rate |
$1,552.91 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,283.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,552.91
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,411.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$962.55
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
OP
|
$6,417.00
|
|
| Hospital Charge Code |
270CH0079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.65 |
| Max. Negotiated Rate |
$3,208.50 |
| Rate for Payer: Aetna Commercial |
$2,438.46
|
| Rate for Payer: Aetna Medicare Advantage |
$1,925.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,636.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,636.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,283.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,636.34
|
| Rate for Payer: Cigna Commercial |
$3,208.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,552.91
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,411.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$962.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$154.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$170.05
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
OP
|
$5,957.00
|
|
| Hospital Charge Code |
270CH0078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.56 |
| Max. Negotiated Rate |
$2,978.50 |
| Rate for Payer: Aetna Commercial |
$2,263.66
|
| Rate for Payer: Aetna Medicare Advantage |
$1,787.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,519.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,519.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,191.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,519.04
|
| Rate for Payer: Cigna Commercial |
$2,978.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,441.59
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,310.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$893.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.86
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
IP
|
$5,942.30
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270653629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
IP
|
$5,957.00
|
|
| Hospital Charge Code |
270CH0080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$893.55 |
| Max. Negotiated Rate |
$1,441.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,191.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,441.59
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,310.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$893.55
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
OP
|
$5,942.30
|
|
| Hospital Charge Code |
270653630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
|
STENT EXPRESS LD ILIAC/BILIARY
|
Facility
|
OP
|
$5,942.30
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270653629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$2,971.15 |
| Rate for Payer: Aetna Commercial |
$2,258.07
|
| Rate for Payer: Aetna Medicare Advantage |
$1,782.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,515.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,188.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,515.29
|
| Rate for Payer: Cigna Commercial |
$2,971.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,438.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,307.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$891.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$143.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$157.47
|
|
