|
CATH 7FR JL 4.5 ST
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.00
|
| Rate for Payer: Oxford Commercial |
$44.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.83
|
|
|
CATH 7FR JL 5.0 ST
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270663274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH 7FR JL 5.0 ST
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.00
|
| Rate for Payer: Oxford Commercial |
$44.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.83
|
|
|
CATH 7FR JL 6.0
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270663275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH 7FR JL 6.0
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.00
|
| Rate for Payer: Oxford Commercial |
$44.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.83
|
|
|
CATH 7FR JR 3.5
|
Facility
|
IP
|
$42.50
|
|
| Hospital Charge Code |
270618292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$6.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.38
|
|
|
CATH 7FR JR 3.5
|
Facility
|
OP
|
$42.50
|
|
| Hospital Charge Code |
270618292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Aetna Commercial |
$16.15
|
| Rate for Payer: Aetna Medicare Advantage |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.84
|
| Rate for Payer: Cigna Commercial |
$21.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.75
|
| Rate for Payer: Oxford Commercial |
$8.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.13
|
|
|
CATH 7FR JR 4.0
|
Facility
|
IP
|
$45.25
|
|
| Hospital Charge Code |
270612749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$6.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.79
|
|
|
CATH 7FR JR 4.0
|
Facility
|
OP
|
$45.25
|
|
| Hospital Charge Code |
270612749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$22.62 |
| Rate for Payer: Aetna Commercial |
$17.20
|
| Rate for Payer: Aetna Medicare Advantage |
$13.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.54
|
| Rate for Payer: Cigna Commercial |
$22.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.57
|
| Rate for Payer: Oxford Commercial |
$9.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.20
|
|
|
CATH 7FR XB 4.5
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.00
|
| Rate for Payer: Oxford Commercial |
$44.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.83
|
|
|
CATH 7FR XB 4.5
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270663272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH 7FR XB LAD 4.5
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270663271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH 7FR XB LAD 4.5
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.00
|
| Rate for Payer: Oxford Commercial |
$44.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$44.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.83
|
|
|
CATH 8*****
|
Facility
|
IP
|
$181.00
|
|
| Hospital Charge Code |
8003469
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.15
|
|
|
CATH 8*****
|
Facility
|
OP
|
$181.00
|
|
| Hospital Charge Code |
8003469
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$90.50 |
| Rate for Payer: Aetna Commercial |
$68.78
|
| Rate for Payer: Aetna Medicare Advantage |
$54.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.16
|
| Rate for Payer: Cigna Commercial |
$90.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.30
|
| Rate for Payer: Oxford Commercial |
$36.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.80
|
|
|
CATH 8FR AL 1.0 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.00
|
| Rate for Payer: Oxford Commercial |
$46.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.09
|
|
|
CATH 8FR AL 1.0 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AL 1.5 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637992
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AL 1.5 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637992
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.00
|
| Rate for Payer: Oxford Commercial |
$46.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.09
|
|
|
CATH 8FR AL 2.0 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AL 2.0 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.00
|
| Rate for Payer: Oxford Commercial |
$46.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.09
|
|
|
CATH 8FR AL .75 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637990
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.00
|
| Rate for Payer: Oxford Commercial |
$46.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.09
|
|
|
CATH 8FR AL .75 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637990
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AR 1.0 100cm
|
Facility
|
OP
|
$247.50
|
|
| Hospital Charge Code |
270637987
|
|
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
|
|
|
CATH 8FR AR 1.0 100cm
|
Facility
|
IP
|
$247.50
|
|
| Hospital Charge Code |
270637987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|